Provider Demographics
NPI:1992721252
Name:GUIDRY, CATHY M (OD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:M
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:MIRZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5725 JOHNSTON ST
Mailing Address - Street 2:SUITE 2314
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5307
Mailing Address - Country:US
Mailing Address - Phone:337-984-2410
Mailing Address - Fax:337-984-2416
Practice Address - Street 1:5725 JOHNSTON ST
Practice Address - Street 2:SUITE 2314
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-5307
Practice Address - Country:US
Practice Address - Phone:337-984-2410
Practice Address - Fax:337-984-2416
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1351-485T-LA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C420C690Medicare ID - Type Unspecified
LAU92293Medicare UPIN