MEDICARE: MRS. MARIA REBECA 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
1	332B00000X	Durable Medical Equipment & Medical Supplies	1000334	TX
2	332BX2000X	Oxygen Equipment & Supplies (DME)	1000334	TX

General Provider Information

NPI Number	:	1780995407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA REBECA GUTIERREZ

Provider Business Mailing Address
First Line	:	9029 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-3603
Country	:	US
Telephone Number	:	713-777-2244
Fax Number	:	713-266-6019

Provider Business Practice Location Address
First Line	:	9029 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-3603
Country	:	US
Telephone Number	:	713-777-2244
Fax Number	:	713-266-6019

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

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	06/28/2010

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