Prasanna K Athyala

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

45D1020447 Issued in TX

Legal business name

PRASANNA K ATHYALA

Doing business as

Permian Clinical Laboratory

Practice address

415 N Jackson Ave
Odessa, TX 79761-5124

Phone

(432) 333-1837

Fax

(432) 333-1856

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Prasanna Kumar Athyala

Title

Medical Laboratory Director

Phone

(432) 333-1837

Specialties & licenses 1

Addresses

Other names 1

• Permian Clinical Laboratory Doing business as

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1225159510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N JACKSON AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615124",
            "telephone_number": "432-333-1837",
            "fax_number": "432-333-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N JACKSON AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615124",
            "telephone_number": "432-333-1837",
            "fax_number": "432-333-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRASANNA K ATHYALA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "ATHYALA",
        "authorized_official_first_name": "PRASANNA",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "MEDICAL LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "432-333-1837",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D1020447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Permian Clinical Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Prado, PHARMD
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• Premier Diagnostic Imaging Inc
• Premise Health of Texas Medical PA (Ector Co - Odessa)

• Clinical Medical Laboratory in Odessa, TX
• Providers in Odessa, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.