Organization
MCH PROFESSIONAL CARE HOSPITAL BASED
Active
Parent organization
MCH PROFESSIONAL CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCH PROFESSIONAL CARE
Authorized official
ADIEL ALVARADO (PRESIDENT)
(432) 640-2401
Entity
Organization
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
207L00000X
Anesthesiology Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
289541901
—
TX
Enumeration date
07/07/2011
Last updated
03/04/2019
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