NPIMap

Organization Active NPI

Up Rao MD PA

  • Gastroenterology Physician
  • Odessa, TX
National Provider Identifier
1861492480
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
F8631 Issued in TX
Legal business name
UP RAO MD PA
Practice address
500 Adams Ave
Suite 700
Odessa, TX 79761-4656
Phone
(432) 334-0433
Fax
(432) 334-0414
NPI assigned
Jul 26, 2005
Last updated
Dec 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
Dr. Udipi Prabhakar Rao, MDNPI 1962698860
Title
Pres. of the Company & Physician
Phone
(432) 334-0433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X F8631 TX Primary

Addresses

Primary practice location

500 Adams Ave
Suite 700
Odessa, TX 79761-4656

Mailing address

500 Adams Ave
Suite 700
Odessa, TX 79761-4656
Phone (432) 334-0433

Other identifiers 2

IdentifierTypeStateIssuer
0075PZOtherTXBLUE CROSS BLUESHIELD
1103947 02MedicaidTX

Other names 1

  • UDIPI Prabhakar RAO MD Former legal business name

National Provider Directory

National Provider Directory

Locations

500 Adams Ave
Ste 700
Odessa, TX 79761
Phone (432) 334-0433

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1861492480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ADAMS AVE",
            "address_2": "SUITE 700",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614656",
            "telephone_number": "432-334-0433",
            "fax_number": "432-334-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ADAMS AVE",
            "address_2": "SUITE 700",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614656",
            "telephone_number": "432-334-0433",
            "fax_number": "432-334-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UP RAO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "RAO",
        "authorized_official_first_name": "UDIPI",
        "authorized_official_middle_name": "PRABHAKAR",
        "authorized_official_title_or_position": "PRES. OF THE COMPANY & PHYSICIAN",
        "authorized_official_telephone_number": "432-334-0433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "F8631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUESHIELD",
            "identifier": "0075PZ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1103947 02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UDIPI Prabhakar RAO MD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 12, 2007; 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.