| Elena Gurova, Md Pa | |
|
519 N Main St Cleburne TX 76033-3845 | |
| (817) 645-5915 | |
| (817) 645-5935 |
| Full Name | Elena Gurova, Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 519 N Main St, Cleburne, Texas |
| Authorized Official Name and Position | Elena Gurova (PRESIDENT AND SECRETALY) |
| Authorized Official Contact | 8176455915 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elena Gurova, Md Pa Po Box 770 Cleburne TX 76033-0770 Ph: (817) 645-5915 | Elena Gurova, Md Pa 519 N Main St Cleburne TX 76033-3845 Ph: (817) 645-5915 |
| NPI Number | 1790862316 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 01/12/2015 |
| Medicare PECOS PAC ID | 3476551771 |
|---|---|
| Medicare Enrollment ID | O20061121000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790862316 | NPI | - | NPPES |
| 183757701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L7404 (Texas) | Primary |
| Provider Name | Elena Gurova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023002144 PECOS PAC ID: 6709809841 Enrollment ID: I20060104000606 |
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