Individual
DR. GENARO JESUS GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4316 JAMES CASEY ST, BLDG B, SUITE 200, AUSTIN, TX 78745-1116
(855) 876-7246
(855) 277-5070
Mailing address
PO BOX 208354, DALLAS, TX 75320-8354
(855) 876-7246
(855) 277-5070
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Q0924
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
Q0924
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
368449YS47
MEDICARE
TX
01
—
368449YYRM
MEDICARE
TX
01
—
Q0924
TEXAS MEDICAL LICENSE
TX
Enumeration date
06/10/2009
Last updated
03/22/2023
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