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Organization

MANISHA DESAI

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MANISHA MAHADEV DESAI M.D. (ORGANIZATION OWNER/PROPRIETER)
(432) 580-0985
Entity
Organization

Contact information

Practice address
400 EAST 6TH STREET STE 100, ODESSA, TX 79761-6947
(432) 580-0985
(432) 337-2666
Mailing address
420 EAST 6TH STREET STE 100, ODESSA, TX 79761-6947
(432) 580-0985
(432) 337-2666

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K6561
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09226801
TX
05
09226802
TX
Enumeration date
09/12/2017
Last updated
09/12/2017
Update your record

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