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Organization
WEST TEXAS DIABETES AND ENDOCRINE CENTER PA
Active
Organization
WEST TEXAS DIABETES AND ENDOCRINE CENTER PA
Active
Parent organization
WEST TEXAS DIABETES AND ENDOCRINE CENTER PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST TEXAS DIABETES AND ENDOCRINE CENTER PA
Authorized official
MR. MURALIDHAR AGUSALA (ADMINISTRATOR)
(432) 332-1144
Entity
Organization
Contact information
Practice address
318 N ALLEGHANEY AVE STE 201, ODESSA, TX 79761-5027
(432) 332-1144
(432) 337-2726
Mailing address
318 N ALLEGHANEY AVE STE 201, ODESSA, TX 79761-5027
(432) 332-1144
(432) 337-2726
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
K6228
TX
174400000X
Specialist
K6230
TX
207QA0505X
Adult Medicine Physician
Primary
K3962
TX
207RC0000X
Cardiovascular Disease Physician
J1178
TX
Other
Enumeration date
05/11/2007
Last updated
01/11/2011
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