Bibiana Gutierrez, PH.D

Individual provider Active NPI Clinical Psychologist · Alpine, TX

NPI 1275720161 · NPPES record last updated Feb 8, 2017

Key facts

NPI
1275720161
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
30732 (TX)
Practice address
500 W Avenue H
Suite 102E
Alpine, TX 79830-6001
Phone
(432) 386-3223
Fax
(432) 837-8104
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
30732TXMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 30732 TX Yes

Addresses

Primary practice location

500 W Avenue H
Suite 102E
Alpine, TX 79830-6001

Mailing address

409 Pinon Dr
Alpine, TX 79830-7507
Phone (432) 386-3223

Other identifiers

IdentifierTypeStateIssuer
30732OtherTXSTATE MEDICAL LICENSE

Other providers in Alpine, TX

All providers in Alpine, TX · Clinical Psychologist in Texas

Sources for this page

Verify at the official NPI Registry.