Individual
VIVEK U RAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 ADAMS AVE, SUITE 300, ODESSA, TX 79761-4656
(432) 333-3300
Mailing address
500 ADAMS AVE, SUITE 300, ODESSA, TX 79761-4656
(432) 333-3300
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
L7855
TX
207R00000X
Internal Medicine Physician
L7855
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005PA
BLUECROSS BLUESHIELD OF TEXAS
TX
01
—
152952100
FIRSTCARE
TX
Enumeration date
07/31/2006
Last updated
05/31/2008
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