Individual
MANOHAR ANGIREKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
720 GOLDER AVE, ODESSA, TX 79761-4442
(432) 337-3117
(432) 337-3117
Mailing address
720 GOLDER AVE, ODESSA, TX 79761-4442
(432) 337-3117
(432) 337-3117
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
L2101
TX
207RC0000X
Cardiovascular Disease Physician
2002-0295
NM
207RC0000X
Cardiovascular Disease Physician
Primary
L2101
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149880003
—
TX
Enumeration date
10/20/2005
Last updated
12/17/2014
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