Individual
ROBERT M GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1721 N LEE TREVINO DR, EL PASO, TX 79936-4563
(915) 590-9424
(915) 590-9049
Mailing address
PO BOX 12520, EL PASO, TX 79913-0520
(915) 842-0504
(915) 842-0448
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
547503
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280350402
—
TX
01
—
TXB139147
INDIVIDUAL PTAN
TX
Enumeration date
05/08/2009
Last updated
10/26/2012
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