Physician Compare National (NPI:1760467963)

HEALTHCARE PROVIDER: CHARLES E GUTIERREZ PH.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1760467963
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668572157
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070712000739
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GUTIERREZ
	Individual professional last name
Provider First Name	CHARLES
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	8401 DATAPOINT DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 301
	Group Practice or individual's line 2 address
City	SAN ANTONIO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	782295904
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y