Healthcare Provider Details
I. General information
NPI: 1801452099
Provider Name (Legal Business Name): OLIVIA JOY GUTIERREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/14/2019
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2727 W HOLCOMBE BLVD
HOUSTON TX
77025-1669
US
IV. Provider business mailing address
11511 SHADOW CREEK PKWY
PEARLAND TX
77584-7298
US
V. Phone/Fax
- Phone: 713-442-0000
- Fax:
- Phone: 713-442-0000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | T8827 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: