Provider Demographics
NPI:1851343628
Name:GUTZMAN, DENNIS RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:RAYMOND
Last Name:GUTZMAN
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 1:2424 BABCOCK RD.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-616-0462
Mailing Address - Fax:210-616-0467
Practice Address - Street 1:2424 BABCOCK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6031
Practice Address - Country:US
Practice Address - Phone:210-616-0462
Practice Address - Fax:210-616-0467
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7102207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10581330OtherCAQH NUMBER
TX5662519OtherAETNA NUMBER
TX00NC42Medicare ID - Type Unspecified
TX10581330OtherCAQH NUMBER