Healthcare Provider Details

I. General information

NPI: 1518140839
Provider Name (Legal Business Name): GARY GUTIERREZ CAMPOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18951 N MEMORIAL DR
HUMBLE TX
77338
US

IV. Provider business mailing address

2606 COMMONWEALTH ST
HOUSTON TX
77006-2609
US

V. Phone/Fax

Practice location:
  • Phone: 281-540-7700
  • Fax:
Mailing address:
  • Phone: 432-967-3882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP10025519
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ2448
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2009-0048
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberQ2448
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: