Basic Information
| Provider Information | |||||||||
| NPI: | 1396720660 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCGUIRE | ||||||||
| FirstName: | ALICE | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3590 | ||||||||
| Address2: | |||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779033590 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3617295357 | ||||||||
| FaxNumber: | 3615764219 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 N MAGNOLIA ST | ||||||||
| Address2: | |||||||||
| City: | ROCKPORT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783822748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3617295357 | ||||||||
| FaxNumber: | 3615764219 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 537591 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | NP8030 | 01 | TX | BCBS OF TX # | OTHER |