Vik Wall, MD | |
500 W 4th St, Odessa, TX 79761-5001 | |
(432) 640-1190 | |
(432) 640-3489 |
Full Name | Vik Wall |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 500 W 4th St, Odessa, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780611806 | NPI | - | NPPES |
8BB102 | Other | TX | BCBSTX PROV. NO. |
137851513 | Medicaid | TX | |
137851520 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | H1675 (Texas) | Primary |
Entity Name | Basin Emergency Physicians Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831337724 PECOS PAC ID: 0244397826 Enrollment ID: O20090326000107 |
Mailing Address | Practice Location Address |
---|---|
Vik Wall, MD 1717 Main St, Suite 5300, Dallas, TX 75201-4605 Ph: (214) 712-2074 | Vik Wall, MD 500 W 4th St, Odessa, TX 79761-5001 Ph: (432) 640-1190 |
Dr. Steven Wiese, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4236 E Everglade Ave, Odessa, TX 79762 Phone: 979-575-8119 | |
Jeffery M Pinnow, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 500 W 4th St, Odessa, TX 79761 Phone: 432-640-4000 | |
Kyungho Scott Choi, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 500 W 4th St, Odessa, TX 79761 Phone: 432-640-4000 | |
Cordell Cunningham, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 500 W 4th St, Odessa, TX 79761 Phone: 432-640-6000 | |
Farshid D Kayfan, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 500 W 4th St, Odessa, TX 79761 Phone: 432-640-1190 Fax: 432-640-3489 | |
Dr. Michael Duane Simmons, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 500 W 4th St, Odessa, TX 79761 Phone: 432-640-1189 | |
Randal Isaac Hale, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 701 W 5th St, Odessa, TX 79763 Phone: 432-335-2222 |