Active NPI
Alvin Costales
- Physical Medicine & Rehabilitation Physician
- Odessa, TX
National Provider Identifier
1467943068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 1299740
- Practice address
- 918 W 20TH St
Odessa, TX 79763-2860 - Phone
- (240) 437-8211
- NPI assigned
- May 21, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 1299740 | TX | Primary |
Addresses
Primary practice location
918 W 20TH St
Odessa, TX 79763-2860
Mailing address
918 W 20TH St
Odessa, TX 79763-2860
Phone (240) 437-8211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 953873894 | Other | TX | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1299740 | TX | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526860800000",
"number": "1467943068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "918 W 20TH ST",
"city": "ODESSA",
"state": "TX",
"postal_code": "797632860",
"telephone_number": "240-437-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "918 W 20TH ST",
"city": "ODESSA",
"state": "TX",
"postal_code": "797632860",
"telephone_number": "240-437-8211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTALES",
"first_name": "ALVIN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-21",
"last_updated": "2018-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "TX",
"license": "1299740",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "953873894",
"state": "TX"
}
],
"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 May 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.