| Permian Digestive Disease Center Pa | |
|
2010 W Ohio Ave Midland TX 79701-5946 | |
| (432) 704-5442 | |
| (432) 704-5443 |
| Full Name | Permian Digestive Disease Center Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2010 W Ohio Ave, Midland, Texas |
| Authorized Official Name and Position | Indira Donepudi (PRESIDENT) |
| Authorized Official Contact | 4327045442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Permian Digestive Disease Center Pa 2010 W Ohio Ave Midland TX 79701-5946 Ph: (432) 704-5442 | Permian Digestive Disease Center Pa 2010 W Ohio Ave Midland TX 79701-5946 Ph: (432) 704-5442 |
| NPI Number | 1386000180 |
|---|---|
| Provider Enumeration Date | 01/08/2016 |
| Last Update Date | 09/18/2019 |
| Medicare PECOS PAC ID | 8820392954 |
|---|---|
| Medicare Enrollment ID | O20160209002862 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386000180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Indira Donepudi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447406137 PECOS PAC ID: 1456419936 Enrollment ID: I20140918000450 |
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