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Organization

PEDS CENTER OF ROUND ROCK PA

Active
Other names
Odessa Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
VIVEKANAND DASARI MD (OWNER)
(201) 289-7621
Entity
Organization

Contact information

Practice address
420 E 6TH ST STE 203, ODESSA, TX 79761-4572
(432) 582-8670
(432) 582-8671
Mailing address
420 E 6TH ST STE 203, ODESSA, TX 79761-4572
(432) 582-8670
(432) 582-8671

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
10/02/2018
Last updated
10/02/2018
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