Adrianne Gutierrez

Individual provider Active NPI Physical Therapy Assistant · Port Lavaca, TX

NPI 1851700611 · NPPES record last updated Aug 6, 2014

Key facts

NPI
1851700611
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2097731 (TX)
Practice address
1300 N Virginia St
Port Lavaca, TX 77979-2509
Phone
(361) 552-5400
Fax
(361) 552-5406
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2097731TXMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2097731 TX Yes

Addresses

Primary practice location

1300 N Virginia St
Port Lavaca, TX 77979-2509

Mailing address

1300 N Virginia St
Port Lavaca, TX 77979-2509
Phone (361) 552-5400

Other providers in Port Lavaca, TX

All providers in Port Lavaca, TX · Physical Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.