Organization Active NPI

Odessa Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Odessa, TX
National Provider Identifier
1215688510
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ODESSA EMERGENCY PHYSICIANS PLLC
Practice address
3800 E 42ND St Ste 105
Odessa, TX 79762-2100
Phone
(432) 552-8208
NPI assigned
Jan 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Montadher Alwazni, MD
Title
Ceo
Phone
(432) 552-8208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

3800 E 42ND St Ste 105
Odessa, TX 79762-2100

Mailing address

PO Box 736889
Dallas, TX 75373-6889
Phone (432) 552-8208

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1215688510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736889",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753736889",
            "telephone_number": "432-552-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 E 42ND ST STE 105",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797622100",
            "telephone_number": "432-552-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODESSA EMERGENCY PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "ALWAZNI",
        "authorized_official_first_name": "MONTADHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "432-552-8208",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.