Organization Active NPI

Womens Wellness of West Texas

  • Obstetrics & Gynecology Physician
  • Odessa, TX
National Provider Identifier
1750057014
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMENS WELLNESS OF WEST TEXAS
Practice address
617 N Tom Green Ave
Odessa, TX 79761-4525
Phone
(432) 333-2229
Fax
(855) 825-9583
NPI assigned
Aug 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Authorized official

Name
Lori Stafford, DONPI 1417181280
Title
Physician, OBGYN
Phone
(432) 250-3180

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
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

617 N Tom Green Ave
Odessa, TX 79761-4525

Mailing address

617 N Tom Green Ave
Odessa, TX 79761-4525
Phone (432) 333-2229

Other practice location 1

3425 Caldera Blvd
Midland, TX 79707-2825
Phone (432) 337-2628

Other identifiers 1

IdentifierTypeStateIssuer
3250888MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL None

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2235205Womens Wellness of West Texas617 North Tom Green Avenue, Odessa, TX 79761Certificate of waiverSep 6, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1750057014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 N TOM GREEN AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614525",
            "telephone_number": "432-333-2229",
            "fax_number": "855-825-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 N TOM GREEN AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614525",
            "telephone_number": "432-333-2229",
            "fax_number": "855-825-9583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3425 Caldera Blvd",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "TX",
            "postal_code": "797072825",
            "country_code": "US",
            "telephone_number": "432-337-2628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WOMENS WELLNESS OF WEST TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2024-02-21",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "STAFFORD",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "PHYSICIAN, OBGYN",
        "authorized_official_telephone_number": "432-250-3180",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3250888",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "None",
            "affiliation": "N",
            "endpointDescription": "None",
            "address_1": "3425 Caldera Blvd",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797072825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.