Provider Demographics
NPI:1831591221
Name:GUILLIOD, RENIE RAFAEL (MD)
Entity type:Individual
Prefix:
First Name:RENIE
Middle Name:RAFAEL
Last Name:GUILLIOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7232 GREENVILLE AVE STE 109
Mailing Address - Street 2:HYPERBARIC MEDICINE UNIT. IEEM
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5129
Mailing Address - Country:US
Mailing Address - Phone:214-345-4613
Mailing Address - Fax:214-345-4647
Practice Address - Street 1:7232 GREENVILLE AVE STE 109
Practice Address - Street 2:HYPERBARIC MEDICINE UNIT. IEEM
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5129
Practice Address - Country:US
Practice Address - Phone:214-345-4613
Practice Address - Fax:214-345-4647
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44634207L00000X
TX45601208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty