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Individual

CHARLES E GUTIERREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
8401 DATAPOINT DR STE 301, SAN ANTONIO, TX 78229-5904
(210) 354-1186
(210) 354-1187
Mailing address
8401 DATAPOINT DR STE301, SAN ANTONIO, TX 78229-5904
(210) 354-1186
(210) 354-1187

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31016
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036343403
TX
01
7979798
CIGNA
TX
01
87436A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/09/2005
Last updated
09/02/2025
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