Provider Demographics
NPI:1376729004
Name:ODESSA CONSULTANTS, LLC
Entity Type:Organization
Organization Name:ODESSA CONSULTANTS, LLC
Other - Org Name:CENTER FOR HYPERTENSION AND INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHU
Authorized Official - Middle Name:
Authorized Official - Last Name:PAMGANAMAMULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-582-2446
Mailing Address - Street 1:PO BOX 3992
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-3992
Mailing Address - Country:US
Mailing Address - Phone:432-582-2446
Mailing Address - Fax:432-582-2960
Practice Address - Street 1:420 E 6TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4529
Practice Address - Country:US
Practice Address - Phone:432-582-2446
Practice Address - Fax:432-582-2960
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ODESSA CONSULTANTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-11
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1155261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y977Medicare PIN