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Contact Information

PERMIAN PEDIATRICS PA
303 E 7TH ST
ODESSA, TX79761
 Phone: 432-582-2929
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PERMIAN PEDIATRICS PA · (Female)

NPI Number 1679022610
Status Active
Credentials
Entity Individual
Enumeration date 10/03/2016
Last updated 05/16/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX Medicaid 367176001
  • TX Medicaid 367176002
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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