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General NPI Number Information
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NPI Number | 1356749642
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Entity Type | Organization
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Legal Business Name | MICHAEL L GUTIERREZ MD PA
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Dates
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Enumeration Date | 12/18/2014
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 1009 E 40TH ST SUITE 300B
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City | AUSTIN
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State | TX
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Zip | 78751-4838
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Country | US
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Telephone | 512-482-8280
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Fax | 512-482-9457
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Provider Business Mailing Address
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Address Line | 1009 E 40TH ST SUITE 300B
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City | AUSTIN
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State | TX
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Zip | 78751-4838
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Country | US
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Telephone | 512-482-8280
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Fax | 512-482-9457
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MICHAEL LOUIS GUTIERREZ
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Credential | MD
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Telephone | 512-482-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | H8097
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License Number State | TX
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