Active NPI
Odessa Emergency Physicians PLLC
- Emergency Medicine Physician
- Odessa, TX
National Provider Identifier
1215688510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 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 DirectoryPractitioners & 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.