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General NPI Number Information
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NPI Number | 1558394601
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Entity Type | Individual
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Provider Name | MANOHER L GURRU M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 3400 ANDREWS HWY
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City | MIDLAND
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State | TX
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Zip | 79703-5100
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Country | US
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Telephone | 432-570-9991
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Fax | 432-570-9998
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Provider Business Mailing Address
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Address Line | PO BOX 4100
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City | MIDLAND
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State | TX
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Zip | 79704-4100
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Country | US
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Telephone | 432-570-9991
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Fax | 432-570-9998
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | L2914
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | L2914
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License Number State | TX
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