| Octavio E. Gutierrez, M.d., P.a. | |
|
1600 N Lee Trevino Dr Ste D2 El Paso TX 79936-5164 | |
| (915) 562-1202 | |
| (915) 599-1414 |
| Full Name | Octavio E. Gutierrez, M.d., P.a. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1600 N Lee Trevino Dr Ste D2, El Paso, Texas |
| Authorized Official Name and Position | Octavio E. Gutierrez (CHILD, ADOLESCENT, ADULT PSYCHIATRY) |
| Authorized Official Contact | 9155621202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Octavio E. Gutierrez, M.d., P.a. Po Box 972777 El Paso TX 79997-2777 Ph: (915) 562-1202 | Octavio E. Gutierrez, M.d., P.a. 1600 N Lee Trevino Dr Ste D2 El Paso TX 79936-5164 Ph: (915) 562-1202 |
| NPI Number | 1376678110 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 08/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376678110 | NPI | - | NPPES |
| 128-487-901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | E4375 (Texas) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | E4375 (Texas) | Secondary |
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