MEDICARE: OZIEL DAVID GUTIERREZ DO

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	207Q00000X	Family Medicine Physician	TXE9364	TX

General Provider Information

NPI Number	:	1821556531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OZIEL DAVID GUTIERREZ DO

Provider Business Mailing Address
First Line	:	16 BYRON NELSON
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-1726
Country	:	US
Telephone Number	:	210-260-2050
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 BYRON NELSON
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-1726
Country	:	US
Telephone Number	:	210-260-2050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2019
Last Update Date	:	03/12/2019

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