Provider Demographics
NPI:1770787210
Name:GUTIERREZ, MAUREEN SHEVLIN (MD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:SHEVLIN
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8220 WALNUT HILL LN
Mailing Address - Street 2:SUITE #314
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4427
Mailing Address - Country:US
Mailing Address - Phone:214-865-7001
Mailing Address - Fax:214-865-7007
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 314
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-865-7001
Practice Address - Fax:214-865-7007
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2012-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD036554207R00000X
VA0101240182207R00000X
TXN0070207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine