Provider Demographics
NPI:1053057703
Name:GUTIERREZ, MARIA DEL PILAR
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL PILAR
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-5355
Mailing Address - Country:US
Mailing Address - Phone:580-651-5178
Mailing Address - Fax:
Practice Address - Street 1:2621 DRIVE OF CHAMPIONS
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79401
Practice Address - Country:US
Practice Address - Phone:806-742-2770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer