Provider Demographics
NPI:1255107405
Name:GUTIERREZ, RICARDO (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 PINEY MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-1750
Mailing Address - Country:US
Mailing Address - Phone:832-907-9504
Mailing Address - Fax:
Practice Address - Street 1:24224 NORTHWEST FWY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5683
Practice Address - Country:US
Practice Address - Phone:281-758-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX299188183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician