Provider Demographics
NPI:1306593926
Name:LEONEL GUTIERREZ
Entity type:Organization
Organization Name:LEONEL GUTIERREZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUTE CARE NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-771-3767
Mailing Address - Street 1:519 CUESTA DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6884
Mailing Address - Country:US
Mailing Address - Phone:956-771-3767
Mailing Address - Fax:
Practice Address - Street 1:10710 MCPHERSON RD STE 300
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6411
Practice Address - Country:US
Practice Address - Phone:956-489-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty