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NPI Code Detail

MEDICARE: MR. LOUIS ANTHONY GUTIERREZ JR.

MEDICARE:  MR. LOUIS ANTHONY GUTIERREZ JR.
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
1390200000XStudent in an Organized Health Care Education/Training Program45733TX

General Provider Information

NPI Number : 1558296194
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LOUIS ANTHONY GUTIERREZ JR.
Provider Business Mailing Address
First Line : 15119 ORPHEUS WAY
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78245-3901
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12125 ALAMO RANCH PKWY
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-4334
Country : US
Telephone Number : 210-688-9584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ MR. LOUIS ANTHONY GUTIERREZ JR. ” Practice Location

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