Individual provider Active NPI

Daniel E Gutierrez, D.O.

  • Neurological Surgery Physician
  • San Antonio, TX
National Provider Identifier
1528091139
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
J9073 Issued in TX
Practice address
1200 Brooklyn Ave Ste 130
San Antonio, TX 78212-4810
Phone
(210) 579-3396
Fax
(844) 485-5407
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X J9073 TX Primary

Addresses

Primary practice location

1200 Brooklyn Ave Ste 130
San Antonio, TX 78212-4810

Mailing address

PO Box 12638
San Antonio, TX 78212-0638
Phone (210) 579-3396

Other practice location 1

1303 McCullough Ave Ste 233
San Antonio, TX 78212-5604
Phone (210) 579-3396

Other identifiers 1

IdentifierTypeStateIssuer
036081003MedicaidTX

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)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1528091139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12638",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782120638",
            "telephone_number": "210-579-3396",
            "fax_number": "844-485-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE STE 130",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124810",
            "telephone_number": "210-579-3396",
            "fax_number": "844-485-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 McCullough Ave Ste 233",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782125604",
            "country_code": "US",
            "telephone_number": "210-579-3396",
            "fax_number": "844-485-5407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "DANIEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "J9073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.