Provider Demographics
NPI:1295222123
Name:GUTIERREZ-HERNANDEZ, SARAH ALICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ALICIA
Last Name:GUTIERREZ-HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:ALICIA
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 161477
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-1477
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18587 SIGMA RD STE 260
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4205
Practice Address - Country:US
Practice Address - Phone:210-314-4564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT99182084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program