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General NPI Number Information
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NPI Number | 1669672572
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Entity Type | Individual
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Provider Name | MARCO GUTIERREZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 401 S ALAMO RD
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City | ALAMO
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State | TX
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Zip | 78516-2501
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Country | US
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Telephone | 956-787-9111
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Fax | 956-683-9440
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Provider Business Mailing Address
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Address Line | 5208 N 10TH ST # 239
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City | MCALLEN
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State | TX
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Zip | 78504-2701
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Country | US
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Telephone | 956-683-8700
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Fax | 956-683-9440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J4177
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License Number State | TX
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