Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G7818 | TX |
Y | 208600000X | Surgeon | G7818 | TX |
N | 2086S0129X | Vascular Surgeon | G7818 | TX |
NPI | 1023083862 |
---|---|
Provider Name | Luis Gutierrez-Perry |
First Address | Eagle Pass, TX 78852-5942 |
Second Address | Eagle Pass, TX 78852-5942 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 17/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114909801 | (05) | TX |
C35186 | (02) | TX |