Organization
RAM KOLLURU,M.D.PA
Active
Other names
PERMIAN HEART CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMACHANDRA RAO KOLLURU M.D. (PRESIDENT)
(432) 685-3333
Entity
Organization
Contact information
Practice address
420 E 6TH ST, STE 102, ODESSA, TX 79761-4529
(432) 685-3333
(432) 570-5440
Mailing address
5 SANTA MARIA CT, ODESSA, TX 79765-8515
(432) 685-3333
(432) 570-5440
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109508502
—
TX
Enumeration date
12/11/2006
Last updated
10/21/2015
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