MEDICARE: DR. NOAH ELVIS 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	207P00000X	Emergency Medicine Physician	MD441237	PA
2	207P00000X	Emergency Medicine Physician	LT4311	NH
3	207R00000X	Internal Medicine Physician	MD441237	PA
4	207R00000X	Internal Medicine Physician	D72380	MD

General Provider Information

NPI Number	:	1699083154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOAH ELVIS GUTIERREZ M.D.

Provider Business Mailing Address
First Line	:	7589B CAMBRIDGE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2009
Country	:	US
Telephone Number	:	347-400-1507
Fax Number	:

Provider Business Practice Location Address
First Line	:	7589B CAMBRIDGE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2009
Country	:	US
Telephone Number	:	347-400-1507
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2010
Last Update Date	:	02/07/2022

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