Basic Information
| Provider Information | |||||||||
| NPI: | 1760460281 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUFFEY | ||||||||
| FirstName: | MANNING | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3328 | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785023328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566824151 | ||||||||
| FaxNumber: | 9566824154 | ||||||||
| Practice Location | |||||||||
| Address1: | 605 E VIOLET AVE STE 6 | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785042469 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566824151 | ||||||||
| FaxNumber: | 9566824154 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 02/22/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 629490 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 153885205 | 05 | TX | MEDICAID | 85184U | 01 | TX | BCBS | OTHER |