Active NPI
Manuel Adrian Gurrola
- Athletic Trainer
- Bryan, TX
National Provider Identifier
1346891330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 4110 College Main St Apt 73
Bryan, TX 77801-3852 - Phone
- (915) 873-6904
- NPI assigned
- Sep 22, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
4110 College Main St Apt 73
Bryan, TX 77801-3852
Mailing address
4110 College Main St Apt 73
Bryan, TX 77801-3852
Phone (915) 873-6904
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Bryan |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569110400000",
"number": "1346891330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4110 COLLEGE MAIN ST APT 73",
"city": "BRYAN",
"state": "TX",
"postal_code": "778013852",
"telephone_number": "915-873-6904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4110 COLLEGE MAIN ST APT 73",
"city": "BRYAN",
"state": "TX",
"postal_code": "778013852",
"telephone_number": "915-873-6904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURROLA",
"first_name": "MANUEL",
"middle_name": "ADRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-22",
"last_updated": "2019-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Bryan",
"affiliation": "N",
"address_1": "4110 College Main St Apt 73",
"city": "Bryan",
"state": "TX",
"country_code": "US",
"postal_code": "778013852",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.