Individual
SUBHASH K NAGALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 E 6TH ST STE 102, ODESSA, TX 79761-4537
(432) 888-9001
(324) 888-9002
Mailing address
420 E 6TH ST STE 102, ODESSA, TX 79761-4537
(432) 888-9001
(324) 888-9002
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036126261
IL
208600000X
Surgery Physician
MD435582
PA
208600000X
Surgery Physician
ME98793
FL
208600000X
Surgery Physician
Primary
P4790
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036126261
MEDICAL LICENSE
IL
01
—
MD435582
MEDICAL LICENSE
PA
01
—
ME98793
MEDICAL LICENSE
FL
01
—
P4790
MEDICAL LICENSE
TX
Enumeration date
06/20/2007
Last updated
01/12/2022
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