Provider Demographics
NPI:1790030997
Name:GUTIERREZ, ROSALBA D (ROSALBA GUTIERREZ)
Entity type:Individual
Prefix:MRS
First Name:ROSALBA
Middle Name:D
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:ROSALBA GUTIERREZ
Other - Prefix:
Other - First Name:ROSALBA
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, IBCLC, RLC
Mailing Address - Street 1:10039 PLANTATION MILL PL
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6529
Mailing Address - Country:US
Mailing Address - Phone:281-725-8200
Mailing Address - Fax:
Practice Address - Street 1:10039 PLANTATION MILL PL
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6529
Practice Address - Country:US
Practice Address - Phone:281-725-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN