Individual
SAMRAJYAM KOLLURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
621 N WASHINGTON AVE, ODESSA, TX 79761-4436
(432) 580-9999
(432) 580-5051
Mailing address
5 SANTA MARIA CT, ODESSA, TX 79765-8515
(432) 272-5852
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H9663
TX
Other
Enumeration date
07/06/2005
Last updated
07/08/2007
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