Odessa Reproductive Medicine Center

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

P0765 Issued in TX

Legal business name

ODESSA REPRODUCTIVE MEDICINE CENTER

Practice address

420 E 6TH St Ste 203
Odessa, TX 79761-4572

Phone

(432) 580-4500

Fax

(432) 218-8804

NPI assigned

Mar 16, 2012

Last updated

May 20, 2014By 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. Mohamed Mitwally, MD, HCLD, FACOGNPI 1790855716

Title

Medical Director

Phone

(248) 701-4157

Specialties & licenses 1

Addresses

Other names 1

• Mitwally Fertility Center Other name

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.

• Mohamed Farouk Mitwally, MD, HCLD, FACOG

  • Reproductive Endocrinology Physician
  • Cleveland, OH
  • NPI 1790855716
  NPD (past) Authorized official

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

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1477828937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CANDELARIA",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234711",
            "telephone_number": "248-701-4157",
            "fax_number": "432-218-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 6TH ST STE 203",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614572",
            "telephone_number": "432-580-4500",
            "fax_number": "432-218-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODESSA REPRODUCTIVE MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-16",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "MITWALLY",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-701-4157",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, HCLD, FACOG"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "TX",
            "license": "P0765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitwally Fertility Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Odessa Physician Associates, PLLC
• Odessa Premium Care
• Odessa Primary Care PLLC
• Odessa Regional Hospital LP
• Odessa Regional Hospital LP
• Odessa Sleep Associates
• Odessa Surgical Associates PA
• Odessa Surgical Services, PLLC
• Odessa Texas Hospital Company LLC (Odessa Regional Medical Center)
• Odessa Texas Hospital Company LLC (Odessa Regional Medical Center)

• Reproductive Endocrinology Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Reproductive Endocrinology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.