Individual
MRS. SHANTHI THANGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
511 N ALLEGHANEY AVE, ODESSA, TX 79761-4405
(432) 337-9000
(432) 337-2545
Mailing address
419 N JACKSON AVE, ODESSA, TX 79761-5124
(432) 337-9000
(432) 337-2545
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
K7111
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046180802
—
TX
Enumeration date
08/09/2006
Last updated
06/07/2018
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