Organization
ALLIANCE MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANIEL OTT MD (OWNER)
(623) 210-6504
Entity
Organization
Contact information
Practice address
6131 E HIGHWAY 191, ODESSA, TX 79762-5348
(432) 366-2911
(432) 366-0790
Mailing address
6131 E HIGHWAY 191, ODESSA, TX 79762-5348
(432) 366-2911
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160257
HEALTH AND HUMAN SERVICES
TX
01
—
160260
HEALTH AND HUMAN SERVICES
TX
01
—
160267
HEALTH AND HUMAN SERVICES
TX
Enumeration date
01/04/2021
Last updated
05/18/2021
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