Organization
PERMIAN BASIN RADIOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M KELLY (PRACTICE MANAGER)
(432) 580-4290
Entity
Organization
Contact information
Practice address
800 E 7TH ST, ODESSA, TX 79761-4612
(432) 580-4290
(432) 332-0229
Mailing address
PO BOX 1268, ODESSA, TX 79760-1268
(432) 580-4290
(432) 332-0229
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006KP
BLUE CROSS BLUE SHIELD
TX
01
—
DA3771
RAILROAD MEDICARE
TX
Enumeration date
08/11/2005
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us