Provider Demographics
NPI:1740701184
Name:OGEDA FAMILY CARE, PLLC
Entity type:Organization
Organization Name:OGEDA FAMILY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CATANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-689-6818
Mailing Address - Street 1:PO BOX 8148
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79708-8148
Mailing Address - Country:US
Mailing Address - Phone:432-689-6818
Mailing Address - Fax:432-689-6901
Practice Address - Street 1:4506 BRIARWOOD AVE STE A
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-2642
Practice Address - Country:US
Practice Address - Phone:432-689-6818
Practice Address - Fax:432-689-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3675261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care