Individual
DR. JORGE LUIS KUTUGATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G9139
TX
208000000X
Pediatrics Physician
Primary
G9139
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117052
SUPERIOR HEALTH PLANS
TX
01
—
85M551
BC/BS OF TEXAS
TX
Enumeration date
08/18/2006
Last updated
09/07/2007
Update your record
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