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Organization
PERMIAN ENDOSCOPY CENTER
Active
Organization
PERMIAN ENDOSCOPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI VEMURU M.D. (PRESIDENT)
(432) 335-8300
Entity
Organization
Contact information
Practice address
315 E 5TH ST, ODESSA, TX 79761-5133
(432) 335-8300
(432) 335-8330
Mailing address
315 E 5TH ST, ODESSA, TX 79761-5133
(432) 335-8300
(432) 335-8330
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH1599
BCBS
TX
01
—
P00081819
RAILROAD MEDICARE
TX
Enumeration date
08/16/2006
Last updated
09/17/2007
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