Provider Demographics
NPI:1063601466
Name:SUZANNE M. GUYNES, M.D.P.A.
Entity type:Organization
Organization Name:SUZANNE M. GUYNES, M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLAIMS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-470-6676
Mailing Address - Street 1:PO BOX 92878
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-0878
Mailing Address - Country:US
Mailing Address - Phone:817-488-5308
Mailing Address - Fax:817-488-7149
Practice Address - Street 1:411 W JOSEPHINE ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5247
Practice Address - Country:US
Practice Address - Phone:817-637-4358
Practice Address - Fax:817-594-5870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH99682084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081120001Medicaid
260045675OtherMEDICARE RAILROAD
TX00763NOtherBLUE CROSS BLUE SHIELD TEXAS
260045675OtherMEDICARE RAILROAD
TX00763NOtherBLUE CROSS BLUE SHIELD TEXAS