Individual
KELASH BAJAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W 3RD ST, ODESSA, TX 79761
(432) 335-8275
(432) 334-0687
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101123456
VA
207RH0003X
Hematology & Oncology Physician
Primary
Q3212
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381708201
—
TX
Enumeration date
06/21/2012
Last updated
11/04/2019
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