Provider Demographics
NPI:1700896313
Name:GUYNES, SUZANNE M (MD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:GUYNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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:817-470-6676
Mailing Address - Fax:541-637-0298
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
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH99682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX260045675OtherMEDICARE RAILROAD
TX8393K0OtherBLUE CROSS BLUE SHIELD TEXAS
TX138008107Medicaid
TX83938K0Medicare PIN
F13681Medicare UPIN