MEDICARE: OLIVIA A. GUTIERREZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	H0413	TX

General Provider Information

NPI Number	:	1013258938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVIA A. GUTIERREZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 73265
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77273-3265
Country	:	US
Telephone Number	:	281-580-9030
Fax Number	:

Provider Business Practice Location Address
First Line	:	3811 MORGANS CRK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-1943
Country	:	US
Telephone Number	:	210-274-1119
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DR. OLIVIA A. GUTIERREZ
Credential	:	MD
Telephone Number	:	210-274-1119

Provider Enumeration Date	:	03/04/2013
Last Update Date	:	03/05/2013

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