Organization
MIDLAND SURGICAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDEEPA MUSUNURU MD (PARTNER)
(432) 697-1061
Entity
Organization
Contact information
Practice address
2405 W MISSOURI AVE, MIDLAND, TX 79701-6800
(432) 697-1061
(432) 697-7089
Mailing address
2405 W MISSOURI AVE, MIDLAND, TX 79701-6800
(432) 697-1061
(432) 697-7089
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0127X
Trauma Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00042F
MEDICARE GROUP PTAN
TX
01
—
0087CG
BLUE CROSS GROUP NUMBER
TX
01
—
CN7004
MEDICARE RAILROAD GROUP
TX
05
—
S0756
—
NM
05
—
Z000042F2
—
TX
Enumeration date
08/31/2006
Last updated
03/13/2023
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