Charles John Gutierrez
Surgeon Vascular Surgeon
350 Pine St Suite 1415
Beaumont
, Texas 77701-2441
Charles John Gutierrez
Surgeon Vascular Surgeon
350 Pine St Suite 1415
Beaumont
, Texas 77701-2441
(409) 924-8607
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About
Features
Specialties
- Surgeon
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Charles John Gutierrez
- 350 Pine St Suite 1415
- Beaumont, TX
- Zip : 77701-2441
- Fax : (409) 924-8607
- Phone : (409) 924-8600
Second Address
- Charles John Gutierrez
- 350 Pine St Suite 1415
- Beaumont, TX
- Zip : 77701-2441
- Fax : (409) 924-8607
- Phone : (409) 924-8600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208200000X | Surgeon | K9794 | TX |
| Y | 208600000X | Surgeon | K9794 | TX |
| N | 2086S0129X | Vascular Surgeon | K9794 | TX |
National Provider Identifier
| NPI | 1104807627 |
|---|---|
| Provider Name | Charles John Gutierrez |
| First Address | Beaumont, TX 77701-2441 |
| Second Address | Beaumont, TX 77701-2441 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/11/2005 |
| Last Update Date | 20/10/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| H14814 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.