Physician Management Services of Western Texas, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHYSICIAN MANAGEMENT SERVICES OF WESTERN TEXAS, LLC

Practice address

4222 Wendover Ave Ste 600
Odessa, TX 79762-5983

Phone

(888) 829-8550

Fax

(888) 829-8550

NPI assigned

Dec 18, 2017

Last updated

Mar 25, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

VAXCARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Brett Kenefick

Title

President

Phone

(888) 829-8550

Specialties & licenses 1

Addresses

Part of

Vaxcare Corporation

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1801302617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 LAWTON RD STE 250",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033517",
            "telephone_number": "888-829-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 WENDOVER AVE STE 600",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625983",
            "telephone_number": "888-829-8550",
            "fax_number": "888-829-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN MANAGEMENT SERVICES OF WESTERN TEXAS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAXCARE CORPORATION",
        "enumeration_date": "2017-12-18",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "KENEFICK",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-829-8550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nguyen Pham, MD
• Thanh Thao Thi Pham
• Travis Cong Pham, MD
• Henry Phe, PHARMD
• Indavong Phonasa, FNP-C
• Physician Network Association (n/a)
• Phytex Rehabilitation, LLC (PhyTEx Rehabilitation & Sports Medicine Associates)
• Phytex Rehabilitation, LLC (PhyTEx West University)
• Deborah L Pickens, M.D.
• Katherine Elizabeth Pierce, MS.CCC/SLP

• Family Medicine Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.