Endovascular Lab PLLC
in Odessa, TX. Organization (NPI-2).
NPI number1407482003
StatusActive
Last updated in NPPESAug 14, 2020
Details
- NPI
- 1407482003
- Entity type
- Organization (NPI-2)
- Legal business name
- Endovascular Lab PLLC
- Organization subpart
- No
- Enumeration date
- Mar 16, 2020
- Certification date
- Aug 14, 2020
- Last updated
- Aug 14, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0129X | – | – | Yes |
Practice location
612 N Washington AvenueSuite 100
Odessa, TX 79761
Phone 432-770-7211
Mailing address
612 N Washington AvenueOdessa, TX 79761
Phone 432-770-7211
Authorized official
James Y Li
President
4327707211
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