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Organization
SURESH PRASAD MD PA
Active
Organization
SURESH PRASAD MD PA
Active
Other names
Permian Internal Medicine Associates
Organization subpart
No
Provider details
NPI number
Authorized official
SURESH PRASAD MD (PHYSICIAN)
(432) 332-3400
Entity
Organization
Contact information
Practice address
601 E 2ND SUITE A, ODESSA, TX 79761
(432) 332-3400
(432) 332-6500
Mailing address
PO BOX 4147, ODESSA, TX 79760
(432) 332-3400
(432) 332-6500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K8430
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0078LW
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/04/2006
Last updated
09/24/2007
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