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Organization
PEDS CENTER OF ROUND ROCK PA
Active
Organization
PEDS CENTER OF ROUND ROCK PA
Active
Other names
Odessa Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
VIVEKANAND DASARI MD (OWNER)
(201) 289-7621
Entity
Organization
Contact information
Practice address
420 E 6TH ST STE 203, ODESSA, TX 79761-4572
(432) 582-8670
(432) 582-8671
Mailing address
420 E 6TH ST STE 203, ODESSA, TX 79761-4572
(432) 582-8670
(432) 582-8671
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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