Provider Demographics
NPI:1720116213
Name:GUTIERREZ, ARNOLDO DANIEL (DC)
Entity Type:Individual
Prefix:
First Name:ARNOLDO
Middle Name:DANIEL
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 BLANCO RD
Mailing Address - Street 2:125
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4360
Mailing Address - Country:US
Mailing Address - Phone:210-366-4357
Mailing Address - Fax:210-366-4359
Practice Address - Street 1:7400 BLANCO RD
Practice Address - Street 2:125
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4360
Practice Address - Country:US
Practice Address - Phone:210-366-4357
Practice Address - Fax:210-366-4359
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5555111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742750876OtherTAX ID
TX605834OtherBCBS
TX5555DCOtherWORKERS COMPENSATION
TX603415Medicare PIN
TXU17417Medicare UPIN