MEDICARE: ANDRES EDUARDO GUTIERREZ ROBLES MD

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	208VP0000X	Pain Medicine Physician	V3312	TX

General Provider Information

NPI Number	:	1790246171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRES EDUARDO GUTIERREZ ROBLES MD

Provider Business Mailing Address
First Line	:	PO BOX 208357
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-8357
Country	:	US
Telephone Number	:	512-485-7208
Fax Number	:	844-364-8678

Provider Business Practice Location Address
First Line	:	305 CLINITE GROVE BLVD
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-2367
Country	:	US
Telephone Number	:	855-876-7246
Fax Number	:	855-277-5070

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

Provider Enumeration Date	:	03/27/2019
Last Update Date	:	12/01/2025

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