Healthcare Provider Details

I. General information

NPI: 1568873909
Provider Name (Legal Business Name): ANA VICTORIA GUTIERREZ ALVAREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 TURLE CREEK
TYLER TX
75701-1833
US

IV. Provider business mailing address

462 FIRST AVENUE HOSPITAL BUILDING 8TH FLOOR (8W52)
NEW YORK NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 903-595-3942
  • Fax: 903-593-2594
Mailing address:
  • Phone: 212-562-6904
  • Fax: 212-562-3273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number12801
License Number StateZZ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberS8184
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: