| Permian Internal Medicine Associates | |
|
601 E 2nd Suite A Odessa TX 79761 | |
| (432) 332-3400 | |
| (432) 332-6500 |
| Full Name | Permian Internal Medicine Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 601 E 2nd Suite A, Odessa, Texas |
| Authorized Official Name and Position | Suresh Prasad (PHYSICIAN) |
| Authorized Official Contact | 4323323400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Permian Internal Medicine Associates Po Box 4147 Odessa TX 79760 Ph: (432) 332-3400 | Permian Internal Medicine Associates 601 E 2nd Suite A Odessa TX 79761 Ph: (432) 332-3400 |
| NPI Number | 1114012283 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 09/24/2007 |
| Medicare PECOS PAC ID | 6204819865 |
|---|---|
| Medicare Enrollment ID | O20040612000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114012283 | NPI | - | NPPES |
| 0078LW | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K8430 (Texas) | Primary |
| Provider Name | Kalpana K Prasad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336247857 PECOS PAC ID: 5991799561 Enrollment ID: I20040414001436 |
| Provider Name | Suresh Prasad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053419572 PECOS PAC ID: 2163332669 Enrollment ID: I20040612000586 |
John H. Doran,m.d., P.l.lc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 Dotsy Ave, Odessa, TX 79763 Phone: 432-333-3295 Fax: 432-333-8840 | |
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