Individual
FREDERICK GUTIERREZ TINIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 GASTON AVE, 4 ROBERTS, DALLAS, TX 75246-2017
(214) 820-3011
Mailing address
3500 GASTON AVE, 4 ROBERTS, DALLAS, TX 75246-2017
(214) 820-3011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD25273
OR
207R00000X
Internal Medicine Physician
Primary
N7885
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281466705
—
TX
01
—
P01062971
MEDICARE RAILROAD
TX
Enumeration date
12/13/2005
Last updated
04/21/2014
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