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NPI Code Detail

MEDICARE: MIRANDA E GUTIERREZ

MEDICARE: MIRANDA E GUTIERREZ
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
1235Z00000XSpeech-Language Pathologist116314TX

General Provider Information

NPI Number : 1760024301
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA E GUTIERREZ
Provider Business Mailing Address
First Line : 7425 LA VISTA DR APT 117
Second Line :
City : DALLAS
State : TX
Zip : 75214-4203
Country : US
Telephone Number : 817-673-0405
Fax Number :
Provider Business Practice Location Address
First Line : 14651 DALLAS PKWY STE 200
Second Line :
City : DALLAS
State : TX
Zip : 75254-8856
Country : US
Telephone Number : 214-575-2999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2019
Last Update Date : 09/14/2020

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Directions to “ MIRANDA E GUTIERREZ ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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