MEDICARE: NUTIS MEDICAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	L5854	TX

General Provider Information

NPI Number	:	1376883439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUTIS MEDICAL PLLC

Provider Business Mailing Address
First Line	:	1150 BURGUNDY DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-3462
Country	:	US
Telephone Number	:	915-228-2491
Fax Number	:	915-219-4890

Provider Business Practice Location Address
First Line	:	1150 BURGUNDY DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-3462
Country	:	US
Telephone Number	:	915-228-2491
Fax Number	:	915-219-4890

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIO NUTIS
Credential	:	M.D.
Telephone Number	:	915-307-2943

Provider Enumeration Date	:	02/26/2013
Last Update Date	:	03/25/2026

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