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Individual

RUSSELL D. SCHROEDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 W 4TH ST, ODESSA, TX 79761-5001
(432) 640-1273
(432) 640-4606
Mailing address
PO BOX 2129, ODESSA, TX 79760-2129
(432) 640-2408
(432) 640-4606

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J6720
TX
2085R0204X
Vascular & Interventional Radiology Physician
J6720
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
167019204
TX
Enumeration date
07/10/2006
Last updated
01/10/2013
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