| Advanced Neuroscience Clinic, Pa | |
|
3400 Andrews Hwy Midland TX 79703-5100 | |
| (432) 570-9991 | |
| (432) 570-9998 |
| Full Name | Advanced Neuroscience Clinic, Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3400 Andrews Hwy, Midland, Texas |
| Authorized Official Name and Position | Manoher L. Gurru (OWNER) |
| Authorized Official Contact | 4325709991 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Neuroscience Clinic, Pa Po Box 4100 Midland TX 79704 Ph: (432) 570-9991 | Advanced Neuroscience Clinic, Pa 3400 Andrews Hwy Midland TX 79703-5100 Ph: (432) 570-9991 |
| NPI Number | 1518003334 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Medicare PECOS PAC ID | 4688662810 |
|---|---|
| Medicare Enrollment ID | O20040505000597 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518003334 | NPI | - | NPPES |
| 0018HQ | Other | TX | BCBS |
| 149225801 | Medicaid | TX |
| Provider Name | Manoher L Gurru |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558394601 PECOS PAC ID: 2668460809 Enrollment ID: I20091009000316 |
| Provider Name | Melanie Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548842453 PECOS PAC ID: 2668546110 Enrollment ID: I20211007000404 |
| Provider Name | Veronica Lujan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225708498 PECOS PAC ID: 3476941816 Enrollment ID: I20211103003072 |
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