Provider Demographics
NPI:1760442982
Name:GUTIERREZ, HUGO PAVEL (LSA)
Entity Type:Individual
Prefix:MR
First Name:HUGO
Middle Name:PAVEL
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 BRIARBEND DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-5003
Mailing Address - Country:US
Mailing Address - Phone:713-417-0440
Mailing Address - Fax:713-729-9853
Practice Address - Street 1:4429 BRIARBEND DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-5003
Practice Address - Country:US
Practice Address - Phone:713-417-0440
Practice Address - Fax:713-729-9853
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00210246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant