Provider Demographics
NPI:1326783267
Name:GUTIERREZ, GABRIELA (RD)
Entity Type:Individual
Prefix:MISS
First Name:GABRIELA
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3641 MATTOX ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1307
Mailing Address - Country:US
Mailing Address - Phone:915-532-6280
Mailing Address - Fax:915-598-3732
Practice Address - Street 1:3641 MATTOX ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1307
Practice Address - Country:US
Practice Address - Phone:915-532-6280
Practice Address - Fax:915-598-3732
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87710133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered