Advanced Neuroscience Clinic, PA

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

L2914 Issued in TX

Legal business name

ADVANCED NEUROSCIENCE CLINIC, PA

Practice address

601 E 2ND St Ste E
Odessa, TX 79761-5435

Phone

(432) 570-9991

Fax

(432) 687-6299

NPI assigned

Mar 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chad Haggerton

Title

Business Office MGR.

Phone

(432) 687-6203

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• Advanced Sleep Center Doing business as

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6114/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manoher L Gurru, M.D.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Midland, TX
  • NPI 1558394601

  Neurology

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1104954049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4100",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797044100",
            "telephone_number": "432-570-9991",
            "fax_number": "432-687-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 2ND ST STE E",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615435",
            "telephone_number": "432-570-9991",
            "fax_number": "432-687-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED NEUROSCIENCE CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "HAGGERTON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "BUSINESS OFFICE MGR.",
        "authorized_official_telephone_number": "432-687-6203"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "L2914",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "M3833",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "L2914",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "M3833",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "TX",
            "license": "L2914",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149225801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "0018HQ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Sleep Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer D Adkins, AGAC-NP
• Mahwish Adnan, MD
• Adolescent & Adult Allergy Center, P.a.
• Reshmi Adupa, MD
• Advanced Fertility Centers,LLC
• Advanced Odessa Hospital & Clinics LLC
• Benjamin Luis Aguilar, FNP
• Miguel Angel Aguilar, PTA
• Angela N Aguirre, COTA
• Ashlea Aguirre

• All providers in Odessa, TX
• Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.