Provider Demographics
NPI:1841562964
Name:GUTHRIE, AUBREY ELTON II (MD,)
Entity Type:Individual
Prefix:DR
First Name:AUBREY
Middle Name:ELTON
Last Name:GUTHRIE
Suffix:II
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 1:3235 RIVER BEND DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-1900
Mailing Address - Country:US
Mailing Address - Phone:817-498-9299
Mailing Address - Fax:
Practice Address - Street 1:3235 RIVER BEND DR
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-1900
Practice Address - Country:US
Practice Address - Phone:817-498-9299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-05
Last Update Date:2012-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC7623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC7623OtherTEXAS MEDICAL BOARD