Provider Demographics
NPI:1063209732
Name:MEDICAL VIP SERVICES PLLC
Entity type:Organization
Organization Name:MEDICAL VIP SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:915-487-1800
Mailing Address - Street 1:1759 RITZ PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4373
Mailing Address - Country:US
Mailing Address - Phone:915-487-1800
Mailing Address - Fax:915-487-1800
Practice Address - Street 1:2829 MONTANA AVE STE 218A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2431
Practice Address - Country:US
Practice Address - Phone:866-891-8424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty