Healthcare Provider Details

I. General information

NPI: 1316783558
Provider Name (Legal Business Name): MSC HEALTH TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10431 GULFDALE ST
SAN ANTONIO TX
78216-4130
US

IV. Provider business mailing address

10431 GULFDALE ST
SAN ANTONIO TX
78216-4130
US

V. Phone/Fax

Practice location:
  • Phone: 210-775-1600
  • Fax: 210-742-1534
Mailing address:
  • Phone: 210-775-1600
  • Fax: 210-742-1534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDRES GUTIERREZ
Title or Position: CEO
Credential:
Phone: 210-775-1600