Active NPI
David Miguel Martin Gutierrez, LSA
- Surgery Physician
- Houston, TX
National Provider Identifier
1407170368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- SA00447
- Practice address
- 11126 Chelsea Oak St
Houston, TX 77065-5478 - Phone
- (832) 493-0969
- Fax
- (832) 575-4762
- NPI assigned
- Mar 22, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | SA00447 | TX | Primary |
Addresses
Primary practice location
11126 Chelsea Oak St
Houston, TX 77065-5478
Mailing address
11126 Chelsea Oak St
Houston, TX 77065-5478
Phone (832) 493-0969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA00447 | TX | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daeva Surgical Limited Liability | Current | Accepting new patients | |
| Houston Surgical Assistant Services | Surgery | Past | Accepting new patients |
| Houston Surgical Assistant Services, Inc. | Surgery | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Surgical Physician Assistant
- Houston, TX
- NPI 1265033252
-
- Surgery Physician
- Houston, TX
- NPI 1184703902
-
- Surgical Physician Assistant
- Houston, TX
- NPI 1861758609
Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1407170368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11126 CHELSEA OAK ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770655478",
"telephone_number": "832-493-0969",
"fax_number": "832-575-4762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11126 CHELSEA OAK ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770655478",
"telephone_number": "832-493-0969",
"fax_number": "832-575-4762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "DAVID MIGUEL",
"middle_name": "MARTIN",
"credential": "LSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-22",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "SA00447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.