Organization Active NPI

Judith and Uche Egbuta LLC

  • Surgery Physician
  • Odessa, TX
National Provider Identifier
1740923341
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
JUDITH AND UCHE EGBUTA LLC
Doing business as
Judith Birungi
Practice address
540 W 5TH St Ste 400
Odessa, TX 79761-5067
Phone
(432) 580-0300
Fax
(432) 580-0306
NPI assigned
Apr 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Dr. Judith Birungi, MDNPI 1609183953
Title
President
Phone
(205) 962-6016

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

540 W 5TH St Ste 400
Odessa, TX 79761-5067

Mailing address

117 Gemini Cir Ste 403
Homewood, AL 35209-5859
Phone (205) 962-6016

Other names 1

  • Judith Birungi Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220609000866 TX Part B Supplier - Clinic/Group Practice 5193103703 Receives reassigned benefits from 1 practitioner
Practice locations: Odessa, TX

National Provider Directory

National Provider Directory

Locations

540 W 5th St
Ste 400
Odessa, TX 79761
Phone (432) 580-0300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1740923341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 GEMINI CIR STE 403",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352095859",
            "telephone_number": "205-962-6016",
            "fax_number": "205-894-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W 5TH ST STE 400",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615067",
            "telephone_number": "432-580-0300",
            "fax_number": "432-580-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDITH AND UCHE EGBUTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-20",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "BIRUNGI",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-962-6016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Judith Birungi",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Judith Birungi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.