| Doctor Name: | DICK STEVEN GUILLORY |
| NPI Number: | 1891948642 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD,06667R |
| Business Practice Address: | 805 Albertson Pkwy Ste C Broussard, LA - 70518 |
| Business Phone Number: | 3378392313 |
| Business Fax Number: | 3378392314 |
| Mailing Address: | 805 Albertson Pkwy Ste C, BROUSSARD |
| State: | LA |
| Postal Code: | 70518 |
| Phone Number: | 3378392313 |
| Fax Number: | 3378392314 |
| NPI Enumeration Date: | 10/24/2008 |
| NPI Last Update Date: | 10/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD,06667R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |