Provider Demographics
NPI:1497730337
Name:GUTTIN, JORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:GUTTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6624 FANNIN
Mailing Address - Street 2:SUITE 2220
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2334
Mailing Address - Country:US
Mailing Address - Phone:713-791-9400
Mailing Address - Fax:713-795-5651
Practice Address - Street 1:6624 FANNIN
Practice Address - Street 2:SUITE 2220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2334
Practice Address - Country:US
Practice Address - Phone:713-791-9400
Practice Address - Fax:713-795-5651
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0804207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8461B7Medicare ID - Type Unspecified
TXB23211Medicare UPIN