Provider Demographics
NPI:1730738097
Name:SOUTHWEST MEDICAL VENTURES PLLC
Entity type:Organization
Organization Name:SOUTHWEST MEDICAL VENTURES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-775-1166
Mailing Address - Street 1:1011 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-4162
Mailing Address - Country:US
Mailing Address - Phone:830-775-1166
Mailing Address - Fax:830-774-8551
Practice Address - Street 1:1011 E 7TH ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4162
Practice Address - Country:US
Practice Address - Phone:830-775-1166
Practice Address - Fax:830-774-8551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty