Organization
MADHAVA AGUSALA MD.,P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHAVA AGUSALA MD. (PRESIDENT)
(432) 337-2714
Entity
Organization
Contact information
Practice address
318 N ALLEGHANEY AVE, STE 402, ODESSA, TX 79761-5052
(432) 337-2714
(432) 337-2726
Mailing address
318 N ALLEGHANEY AVE, STE 402, ODESSA, TX 79761-5052
(432) 337-2714
(432) 337-2726
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
K3962
TX
207RC0000X
Cardiovascular Disease Physician
Primary
J1178
TX
Other
Enumeration date
04/12/2007
Last updated
06/26/2009
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