Individual
DR. JORGE LUIS KUTUGATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
902 S AIRPORT DR STE 1, WESLACO, TX 78596-6649
(956) 969-2904
(956) 969-1650
Mailing address
902 S AIRPORT DR STE 1, WESLACO, TX 78596-6649
(956) 969-2904
(956) 969-1650
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
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