Organization
UP RAO MD PA
Active
Other names
UDIPI Prabhakar RAO MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. UDIPI PRABHAKAR RAO MD (PRES. OF THE COMPANY & PHYSICIAN)
(432) 334-0433
Entity
Organization
Contact information
Practice address
500 ADAMS AVE, SUITE 700, ODESSA, TX 79761-4656
(432) 334-0433
(432) 334-0414
Mailing address
500 ADAMS AVE, SUITE 700, ODESSA, TX 79761-4656
(432) 334-0433
(432) 334-0414
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
F8631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0075PZ
BLUE CROSS BLUESHIELD
TX
05
—
1103947 02
—
TX
Enumeration date
07/26/2005
Last updated
12/12/2007
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