Organization
PERMIAN NEPHROLOGY ASSOCIATES PA
Active
Organization
PERMIAN NEPHROLOGY ASSOCIATES PA
Active
Other names
Desert Milagro Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D. OLIVER (OWNER)
(432) 522-2304
Entity
Organization
Contact information
Practice address
230 N WASHINGTON AVE, ODESSA, TX 79761-5424
(432) 580-8181
(432) 580-4259
Mailing address
230 N WASHINGTON AVE, ODESSA, TX 79761-5424
(432) 580-8181
(432) 580-4259
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/02/2008
Last updated
11/04/2009
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