Individual provider Active NPI

Eduardo Gutierrez, PA

  • Physician Assistant
  • San Marcos, TX
National Provider Identifier
1780631119
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02628 Issued in TX
Practice address
1301 Wonder World Dr
San Marcos, TX 78666-7533
Phone
(512) 753-3796
NPI assigned
May 30, 2006
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA02628 TX Primary

Addresses

Primary practice location

1301 Wonder World Dr
San Marcos, TX 78666-7533

Mailing address

310 Long MDW
Spring Branch, TX 78070-5929
Phone (210) 884-3308

Other practice location 1

1659 TX-46 Ste 160
New Braunfels, TX 78132
Phone (830) 387-4991

Other identifiers 2

IdentifierTypeStateIssuer
8N9945OtherTXBCBS
182883201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060509000965 TX Practitioner - Physician Assistant 4183635808 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1659 Hwy 46 W
Suite 160
New Braunfels, TX 78132-4746
Phone (830) 643-5287

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.62 of 100Reported as group
Quality
92.03
Improvement activities
40
Cost
85.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA02628TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Feb 4, 2026 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Feb 4, 2026 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

1659 Highway 46 W
Ste 160
New Braunfels, TX 78132
Phone (830) 387-4491

555 Creekside Xing
New Braunfels, TX 78130
Phone (830) 387-4660

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1780631119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LONG MDW",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "780705929",
            "telephone_number": "210-884-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WONDER WORLD DR",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667533",
            "telephone_number": "512-753-3796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1659 TX-46 STE 160",
            "address_purpose": "LOCATION",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "78132",
            "country_code": "US",
            "telephone_number": "830-387-4991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "EDUARDO",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N9945",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182883201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.