Alliance Medical Group PLLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

ALLIANCE MEDICAL GROUP PLLC

Practice address

6131 E Highway 191
Odessa, TX 79762-5348

Phone

(432) 366-2911

Fax

(432) 366-0790

NPI assigned

Jan 4, 2021

Last updated

May 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nathaniel Ott, MDNPI 1679983480

Title

Owner

Phone

(623) 210-6504

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nathaniel Ott, M.D.

  • General Practice Physician
  • Dallas, TX
  • NPI 1679983480
  Authorized official Same address or phone

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1366030538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6131 E HIGHWAY 191",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625348",
            "telephone_number": "432-366-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6131 E HIGHWAY 191",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625348",
            "telephone_number": "432-366-2911",
            "fax_number": "432-366-0790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 E Loop 281",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756057906",
            "country_code": "US",
            "telephone_number": "903-553-0911",
            "fax_number": "903-236-5075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 North St",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759614037",
            "country_code": "US",
            "telephone_number": "936-569-0911",
            "fax_number": "936-569-9131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLIANCE MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-210-6504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AND HUMAN SERVICES",
            "identifier": "160260",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AND HUMAN SERVICES",
            "identifier": "160257",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AND HUMAN SERVICES",
            "identifier": "160267",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.excelerodessa.com",
            "affiliation": "N",
            "address_1": "6131 E Highway 191",
            "city": "Odessa",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797625348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Emergency Medicine Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.