Sudhir Amaram, M.D.

Key facts

NPI

1124017173

Entity type

Individual (NPI type 1)

Primary specialty

Cardiovascular Disease Physician 207RC0000X

License

F8392 (TX)

Practice address

720 Golder Ave
Odessa, TX 79761-4442

Phone

(432) 337-3117

Fax

(432) 337-3448

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

No

Organizations & group practices 2

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.

• A & D Medical Center, LLC Rural Health Clinic/Center · Monahans, TX · NPI 1295793214
  NPD (past)
• Ector County Hospital District Urgent Care Clinic/Center · Odessa, TX · NPI 1366680555
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sudhir.amaram.1@17949.direct.athenahealth.com

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 18, 2014.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1124017173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 GOLDER AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614442",
            "telephone_number": "432-337-3117",
            "fax_number": "432-337-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 GOLDER AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614442",
            "telephone_number": "432-337-3117",
            "fax_number": "432-337-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARAM",
        "first_name": "SUDHIR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "F8392",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "F8392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128633807",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Odessa, TX · Cardiovascular Disease Physician in Texas