Permian Basin Kidney Center INC
Internal Medicine, Nephrology in Odessa, TX. Organization (NPI-2).
NPI number1285199026
StatusActive
Last updated in NPPESDec 8, 2022
Details
- NPI
- 1285199026
- Entity type
- Organization (NPI-2)
- Legal business name
- Permian Basin Kidney Center INC
- Organization subpart
- No
- Enumeration date
- Feb 6, 2019
- Certification date
- Dec 8, 2022
- Last updated
- Dec 8, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RN0300X | Internal Medicine, Nephrology | – | – | Yes |
Practice location
410 N Hancock AveOdessa, TX 79761-5140
Phone 432-279-0905 · Fax 432-279-0904
Mailing address
410 N Hancock AveOdessa, TX 79761-5140
Phone 432-279-0905 · Fax 432-279-0904
Authorized official
Anand Reddy
Owner
3143787270
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