West Texas Diabetes and Endocrine Center PA

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

K3962 Issued in TX

Legal business name

WEST TEXAS DIABETES AND ENDOCRINE CENTER PA

Practice address

318 N Alleghaney Ave Ste 201
Odessa, TX 79761-5027

Phone

(432) 332-1144

Fax

(432) 337-2726

NPI assigned

May 11, 2007

Last updated

Jan 11, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

WEST TEXAS DIABETES AND ENDOCRINE CENTER PAAs reported in NPPES

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

Authorized official

Name

Mr. Muralidhar Agusala

Title

Administrator

Phone

(432) 332-1144

Specialties & licenses 4

Addresses

Other identifiers 3

Part of

West Texas Diabetes and Endocrine Center PA

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10465/brand/1/csg/1/fhir/r4

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.

• Madhava Agusala, M.D.

  • Cardiovascular Disease Physician
  • Odessa, TX
  • NPI 1700915303
  NPD

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1891900080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 N ALLEGHANEY AVE STE 201",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615027",
            "telephone_number": "432-332-1144",
            "fax_number": "432-337-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N ALLEGHANEY AVE STE 201",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615027",
            "telephone_number": "432-332-1144",
            "fax_number": "432-337-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS DIABETES AND ENDOCRINE CENTER PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST TEXAS DIABETES AND ENDOCRINE CENTER PA",
        "enumeration_date": "2007-05-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "AGUSALA",
        "authorized_official_first_name": "MURALIDHAR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "432-332-1144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K6230",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K6228",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TX",
            "license": "K3962",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "J1178",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030349701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126502701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080422101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wes Tex Urgent Care, PLLC
• Wes Tex Urgent Care, PLLC
• West Coke County Hospital District (Parks Health Center)
• West Texas Cardiology PA
• West Texas Counselling and Rehabilitation Program of Odessa, Inc. (WTCR Odessa, Inc.)
• West Texas Excel ER Physicians, PLLC
• West Texas Geriatrics LLC
• West Texas Imaging Center PA
• West Texas Maternal Fetal Medicine Center, LLC
• West Texas Neurosurgery PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.