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

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.

Title

President

Phone

(254) 776-0266

Specialties & licenses 1

Addresses

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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• 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.