Brent L Kutach DO PA

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

K6070 Issued in TX

Legal business name

BRENT L KUTACH DO PA

Practice address

405 Londonderry Dr
Suite 105
Waco, TX 76712-7924

Phone

(254) 776-0266

Fax

(254) 776-2511

NPI assigned

Mar 23, 2006

Last updated

Apr 3, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brent L Kutach, D.O.NPI 1821187402

Title

President

Phone

(254) 776-0266

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent L Kutach, D.O.

  • Anesthesiology Physician
  • Waco, TX
  • NPI 1821187402
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1013976323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR",
            "address_2": "SUITE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127924",
            "telephone_number": "254-776-0266",
            "fax_number": "254-776-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR",
            "address_2": "SUITE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127924",
            "telephone_number": "254-776-0266",
            "fax_number": "254-776-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT L KUTACH DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "KUTACH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-776-0266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K6070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Waco, TX
• Providers in Waco, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.