Provider Demographics
NPI:1992315709
Name:TORRES GUTIERREZ, MARCELA
Entity type:Individual
Prefix:
First Name:MARCELA
Middle Name:
Last Name:TORRES GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARCELA
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5001 S COOPER ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5993
Mailing Address - Country:US
Mailing Address - Phone:866-367-8768
Mailing Address - Fax:
Practice Address - Street 1:400 W IH 635 STE 300
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75064-6329
Practice Address - Country:US
Practice Address - Phone:866-367-8768
Practice Address - Fax:817-541-9301
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16242363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant