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Individual

DR. MARCO GUTIERREZ

Active
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Individual

DR. MARCO GUTIERREZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J4177
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137950513
—
TX
05
—
292450801
—
TX
01
—
45D1003540
CLIA # (ALAMO CLINIC)
TX
01
—
45D1052653
CLIA # (MCALLEN CLINIC)
TX
01
—
8G6960
BCBS OF TX
TX
Enumeration date
07/19/2007
Last updated
04/07/2022
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