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General NPI Number Information
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NPI Number | 1952396947
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Entity Type | Individual
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Provider Name | ANA MARIA BAUTISTA-GUTIERREZ MD
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Gender | Female
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 7530 NW 25TH ST STE B
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City | BETHANY
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State | OK
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Zip | 73008-4914
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Country | US
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Telephone | 405-495-6340
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Fax | 405-440-9951
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Provider Business Mailing Address
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Address Line | 7530 NW 25TH ST STE B
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City | BETHANY
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State | OK
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Zip | 73008-4914
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Country | US
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Telephone | 405-495-6340
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Fax | 405-440-9951
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 15052
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License Number State | OK
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