Provider Demographics
NPI:1003851676
Name:GUTSMANN, ASTRID (DO, PHD)
Entity Type:Individual
Prefix:DR
First Name:ASTRID
Middle Name:
Last Name:GUTSMANN
Suffix:
Gender:F
Credentials:DO, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 E MCDERMOTT DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2854
Mailing Address - Country:US
Mailing Address - Phone:972-227-3464
Mailing Address - Fax:972-359-9690
Practice Address - Street 1:411 E MCDERMOTT DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-2854
Practice Address - Country:US
Practice Address - Phone:972-227-3464
Practice Address - Fax:972-359-9690
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0031NKOtherBCBS TX
TX0031NKOtherBCBS TX
TXI53638Medicare UPIN