Provider Demographics
NPI:1992934905
Name:CHARLES JOSEPH GUIDRY JR
Entity type:Organization
Organization Name:CHARLES JOSEPH GUIDRY JR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:JR
Authorized Official - Credentials:LBSW
Authorized Official - Phone:713-270-1541
Mailing Address - Street 1:9000 SOUTHWEST FWY
Mailing Address - Street 2:400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1526
Mailing Address - Country:US
Mailing Address - Phone:713-270-1541
Mailing Address - Fax:713-270-7999
Practice Address - Street 1:9000 SOUTHWEST FWY
Practice Address - Street 2:400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1526
Practice Address - Country:US
Practice Address - Phone:713-270-1541
Practice Address - Fax:713-270-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-11
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN37435104100000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty