Provider Demographics
NPI:1184802407
Name:SARA M GUIDO D C P A
Entity type:Organization
Organization Name:SARA M GUIDO D C P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUIDO
Authorized Official - Suffix:
Authorized Official - Credentials:DC,PA
Authorized Official - Phone:9155-945-8298
Mailing Address - Street 1:11570 PELLICANO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6050
Mailing Address - Country:US
Mailing Address - Phone:915-594-8298
Mailing Address - Fax:915-594-8972
Practice Address - Street 1:11570 PELLICANO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6050
Practice Address - Country:US
Practice Address - Phone:915-594-8298
Practice Address - Fax:915-594-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC0841OtherRAILROAD MEDICARE
TX170669901Medicaid
TX00440WMedicare PIN