Provider Demographics
NPI:1679183081
Name:GUTIERREZ, BRIANNA LINN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LINN
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 FRATT RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-4486
Mailing Address - Country:US
Mailing Address - Phone:210-646-0295
Mailing Address - Fax:
Practice Address - Street 1:6520 FRATT RD STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-4486
Practice Address - Country:US
Practice Address - Phone:210-646-0295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-01
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist