| Complete Kidney Care | |
|
318 N Alleghaney Ave Suite 200 Odessa TX 79761-5052 | |
| (432) 558-0497 | |
| (432) 558-0498 |
| Full Name | Complete Kidney Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 318 N Alleghaney Ave, Odessa, Texas |
| Authorized Official Name and Position | Ronald Oscar Gibbons (PRESIDENT) |
| Authorized Official Contact | 4325580497 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Kidney Care 3323 N Midland Dr Suite 113-106 Midland TX 79707-4608 Ph: (432) 558-0497 | Complete Kidney Care 318 N Alleghaney Ave Suite 200 Odessa TX 79761-5052 Ph: (432) 558-0497 |
| NPI Number | 1306111877 |
|---|---|
| Provider Enumeration Date | 03/17/2012 |
| Last Update Date | 07/03/2012 |
| Medicare PECOS PAC ID | 4981868031 |
|---|---|
| Medicare Enrollment ID | O20120621000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306111877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | N0787 (Texas) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | N0787 (Texas) | Primary |
| Provider Name | Ronald O Gibbons |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1598828824 PECOS PAC ID: 5698871713 Enrollment ID: I20070507000572 |
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