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ALEXANDER ANDRES BASTIDAS PALACIOS

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) 640-2401
(432) 640-4606
Mailing address
PO BOX 2129, ODESSA, TX 79760-2129
(432) 640-2401
(432) 640-4606

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
P9805
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
339323301
TX
Enumeration date
06/29/2009
Last updated
04/06/2016
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