Organization Active NPI

Odessa Primary Care PLLC

  • Internal Medicine Physician
  • Odessa, TX
National Provider Identifier
1922988690
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ODESSA PRIMARY CARE PLLC
Practice address
601 Golder Ave Ste B
Odessa, TX 79761-4412
Phone
(866) 439-3165
Fax
(832) 413-4493
NPI assigned
Sep 4, 2025
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Syed Ahmed
Title
Administrator
Phone
(832) 205-2456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

601 Golder Ave Ste B
Odessa, TX 79761-4412

Mailing address

601 Golder Ave Ste B
Odessa, TX 79761-4412
Phone (866) 439-3165

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250918004824 TX Part B Supplier - Clinic/Group Practice 5991209298 Receives reassigned benefits from 1 practitioner
Practice locations: Odessa, TX

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
45D2338901Odessa Primary Care601 Golder Ave, Odessa, TX 79761Certificate of waiverFeb 18, 2028

National Provider Directory

National Provider Directory

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": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1922988690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GOLDER AVE STE B",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614412",
            "telephone_number": "866-439-3165",
            "fax_number": "832-413-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GOLDER AVE STE B",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614412",
            "telephone_number": "866-439-3165",
            "fax_number": "832-413-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODESSA PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "SYED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "832-205-2456"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.