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Individual

DR. ELENA GUROVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
519 N MAIN ST, CLEBURNE, TX 76033-3845
(817) 645-5915
(817) 645-5935
Mailing address
PO BOX 770, CLEBURNE, TX 76033-0770
(817) 645-5915
(817) 645-5935

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2002-0425
NM
207R00000X
Internal Medicine Physician
Primary
L7404
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
158386603
TX
01
45D1056377
CLIA WAIVER NUMBER
TX
01
J0130220
TEXAS DPS NUMBER
TX
Enumeration date
09/02/2005
Last updated
03/07/2023
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