Individual
ERON GRANT MANUSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2106 TREASURE HILLS BLVD # 1.326, HARLINGEN, TX 78550-8736
(956) 296-1519
(956) 296-1331
Mailing address
PO BOX 531968, HARLINGEN, TX 78553-1968
(338) 887-4863
(956) 296-6857
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P8943
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
P8943
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337122104
—
TX
01
—
337122105
MEDICAID - CSHCN
TX
01
—
H08FR76401
BCBS
TX
Enumeration date
01/24/2006
Last updated
04/29/2024
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