Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Eric Manthuruthil, PA-C

Individual provider Physician Assistant · NPI 1255790796

Mr. Eric Manthuruthil, PA-C is a Physician Assistant in Dallas, Texas. Qualified in 2015, 11 years ago. Practices with Legacy Urgent Care PA, a 158-clinician group and works from 2 locations. Licensed in Texas.

Years since qualifying
11
Licensed in
TX
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5939 Harry Hines Blvd
Dallas, TX 75390
Phone: (214) 645-2100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 207 Enchanted Ct, Grand Prairie, TX 75050-8064 — (817) 707-5636

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA10504 (TX)
Physician Assistant Taxonomy 363A00000X (TX)

Record details

NPI number1255790796
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedFebruary 12, 2016
Last updated in NPPESAugust 23, 2019
Mailing addressPo Box 845347, Dallas, TX 75284-7208

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Legacy Urgent Care Pa — 158 clinicians
Accepts Medicare assignment Not indicated
Practice locations5 on file with Medicare

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