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NPI Code Detail

MEDICARE: DR. DANIEL GUTIERREZ MD

MEDICARE:  DR. DANIEL  GUTIERREZ  MD
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
12084P0804XChild & Adolescent Psychiatry PhysicianH9967TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
210078938OTHERTXDPS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4816090OTHERTXBLUE SHIELD OF TEXAS

General Provider Information

NPI Number : 1982663654
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL GUTIERREZ MD
Provider Business Mailing Address
First Line : 1901 S 24TH AVE
Second Line :
City : EDINBURG
State : TX
Zip : 78539-6533
Country : US
Telephone Number : 956-289-7000
Fax Number : 956-289-7257
Provider Business Practice Location Address
First Line : 1901 S 24TH AVE
Second Line :
City : EDINBURG
State : TX
Zip : 78539-6533
Country : US
Telephone Number : 956-289-7000
Fax Number : 956-289-7257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2006
Last Update Date : 03/07/2023

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Directions to “ DR. DANIEL GUTIERREZ MD” Practice Location

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