Provider Demographics
NPI:1992791115
Name:GUIDO, SARA MARIE (DC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:GUIDO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11570 PELLICANO DR
Mailing Address - Street 2:STE A
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:STE A
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
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
606104OtherBCBS
U39626Medicare UPIN
8B7239Medicare ID - Type Unspecified