Provider Demographics
NPI:1437978368
Name:GUTSCH, JASON (DC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:GUTSCH
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 1:40390 KELLEY RD
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:TX
Mailing Address - Zip Code:77445-7813
Mailing Address - Country:US
Mailing Address - Phone:903-436-5540
Mailing Address - Fax:
Practice Address - Street 1:1206 11TH ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:TX
Practice Address - Zip Code:77445-5260
Practice Address - Country:US
Practice Address - Phone:903-436-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor