Active NPI
Prem Vindhya, M.D.
- Anesthesiology Physician
- Odessa, TX
National Provider Identifier
1093894719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G6039
- Practice address
- 500 W 4TH St
Odessa, TX 79761-5001 - Phone
- (432) 640-2401
- Fax
- (432) 640-1118
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G6039 | TX | Primary |
Addresses
Primary practice location
500 W 4TH St
Odessa, TX 79761-5001
Mailing address
PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-2401
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8K1301 | Other | TX | BLUE SHIELD AND BLUE CROSS |
| 120414107 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCH Professional Care | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313712000000",
"number": "1093894719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2129",
"city": "ODESSA",
"state": "TX",
"postal_code": "797602129",
"telephone_number": "432-640-2401",
"fax_number": "432-640-1118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W 4TH ST",
"city": "ODESSA",
"state": "TX",
"postal_code": "797615001",
"telephone_number": "432-640-2401",
"fax_number": "432-640-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINDHYA",
"first_name": "PREM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2011-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "G6039",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD AND BLUE CROSS",
"identifier": "8K1301",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120414107",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.