| Gutierrez Md Pllc | |
|
612 N Bedell Ave Ste A Del Rio TX 78840-4173 | |
| (830) 775-1166 | |
| (830) 774-8551 |
| Full Name | Gutierrez Md Pllc |
|---|---|
| Speciality | General Practice |
| Location | 612 N Bedell Ave Ste A, Del Rio, Texas |
| Authorized Official Name and Position | Jaime Javier Gutierrez (PHYSICIAN) |
| Authorized Official Contact | 8307656622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gutierrez Md Pllc 100 Encino Dr Del Rio TX 78840-2240 Ph: (830) 765-6622 | Gutierrez Md Pllc 612 N Bedell Ave Ste A Del Rio TX 78840-4173 Ph: (830) 775-1166 |
| NPI Number | 1528385689 |
|---|---|
| Provider Enumeration Date | 04/29/2010 |
| Last Update Date | 04/23/2012 |
| Medicare PECOS PAC ID | 7113050097 |
|---|---|
| Medicare Enrollment ID | O20100728001175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528385689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | J9880 (Texas) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | J9880 (Texas) | Secondary |
| Provider Name | Jaime J Gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922155506 PECOS PAC ID: 0547245128 Enrollment ID: I20040618001072 |
| Provider Name | Paloma B Solis Cariaga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699030536 PECOS PAC ID: 2567619109 Enrollment ID: I20120904000315 |
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