Provider Demographics
NPI:1265301170
Name:GUTIERREZ, FELIPE FERNANDO JR (OD)
Entity type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:FERNANDO
Last Name:GUTIERREZ
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 DATE PALM DR
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6496
Mailing Address - Country:US
Mailing Address - Phone:956-573-1260
Mailing Address - Fax:
Practice Address - Street 1:7600 N 10TH ST STE 600G
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-7716
Practice Address - Country:US
Practice Address - Phone:956-800-6870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11555152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty