Eileen Li, MD

Individual provider Active NPI Pediatrics Physician · Odessa, TX

NPI 1598723975 · NPPES record last updated Feb 23, 2012

Key facts

NPI
1598723975
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
M1882 (TX)
Practice address
540 W 5TH St
Suite 360
Odessa, TX 79761-5034
Phone
(432) 332-7337
Fax
(432) 332-9264
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M1882TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eileen Li MD PA Pediatrics Past
since Apr 13, 2006
Accepting new patients
James Y Li MD PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M1882 TX Yes

Addresses

Primary practice location

540 W 5TH St
Suite 360
Odessa, TX 79761-5034

Mailing address

540 W 5TH St
Suite 360
Odessa, TX 79761-5034
Phone (432) 332-7337

Other identifiers

IdentifierTypeStateIssuer
180422101MedicaidTX

Other providers in Odessa, TX

All providers in Odessa, TX · Pediatrics Physician in Texas

Sources for this page

Verify at the official NPI Registry.