PERMIAN BASIN COMMUNITY CENTERS FOR MHMR (NPI# 1073614624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073614624 |
| Entity Type | Organization |
| Organization Name | PERMIAN BASIN COMMUNITY CENTERS FOR MHMR |
| Practice Address |
1111 W 12th Street Odessa TX 79763 |
| Mailing Address |
701 E Illinois Ste 400 Midland TX 79701 |
| Practice Telephone | 4323333265 |
| Practice Fax Number | 4325703346 |
| Mailing Telephone | 4325703333 |
| Mailing Fax Number | 4325703346 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. RAMONA THOMAS (DEPUTY EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4325703333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| X | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558407122 | Permian Basin Community Centers for Mhmr | Community/Behavioral Health | 400 N Carver St, Midland, TX 79701 | 2007-01-30 |
| 1548361199 | Permian Basin Community Centers for Mhmr | Intermediate Care Facility, Mentally Retarded | 5256 Morris St, Odessa, TX 79705 | 2006-09-26 |
| 1679681597 | Permian Basin Community Centers for Mhmr | Clinic/Center | 502 N Carver, Midland, TX 79701 | 2006-08-29 |
| 1477560068 | Permian Basin Community Centers for Mhmr | Clinic/Center | 401 E Illinois Ave, Ste 400, Midland, TX 79701 | 2006-08-03 |
| 1487669875 | Permian Basin Community Centers for Mhmr | Clinic/Center | 3701 N Big Spring, Midland, TX 79702 | 2006-07-31 |
| 1619011525 | Permian Basin Community Centers for Mhmr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 400 N Carver St, Midland, TX 79701 | 2007-02-16 |
| 1184795064 | Permian Basin Community Centers for Mhmr | Psychiatry & Neurology | 401 E Illinois Ave, Ste 400, Midland, TX 79701 | 2006-11-13 |
| 1043381924 | Permian Basin Community Centers for Mhmr | Psychiatry & Neurology | 1111 W 12th Street, Odessa, TX 79763 | 2006-11-13 |
| 1801806021 | Permian Basin Community Centers for Mhmr | Clinic/Center | 401 E Illinois Ave, Ste 200, Midland, TX 79701 | 2006-08-09 |
| 1306855465 | Permian Basin Community Centers for Mhmr | Clinic/Center | 401 E Illinois Ave, Ste 200, Midland, TX 79701 | 2006-08-07 |
| Street Address |
1111 W 12TH STREET |
| City | ODESSA |
| State | TX |
| Zip Code | 79763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699835462 | Carron Lou Shellenberger | Counselor | 1111 W 12th Street, Odessa, TX 79763 | 2006-12-11 |
| 1043381924 | Permian Basin Community Centers for Mhmr | Psychiatry & Neurology | 1111 W 12th Street, Odessa, TX 79763 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164885 | Mary Ewusie | Pharmacist | 2450 West Loop 3378, Odessa, TX 79763 | 2020-11-03 |
| 1982231569 | Yashica Patel | Student in an Organized Health Care Education/Training Program | 701 W. 5th St, Suite 1229, Odessa, TX 79763 | 2020-03-24 |
| 1144740457 | Devi Priya Suravajjala | Student in an Organized Health Care Education/Training Program | 701,w 5th Street, Odessa, TX 79763 | 2017-06-27 |
| 1649640392 | Elesea Celeste Villegas | Physician Assistant | 701 West 5th Street, Odessa, TX 79763 | 2015-10-06 |
| 1790046472 | Kathryn Nichole Hutton | Obstetrics & Gynecology | 701 W 5th Street, Odessa, TX 79763 | 2012-05-30 |
| 1962761791 | Marvin Ryan Harvey | Family Medicine | 701 W 5th St Ste 3174, Odessa, TX 79763 | 2012-05-14 |
| 1245529544 | Yvette Garcia | Counselor | 1012 W Macarthur, Odessa, TX 79763 | 2011-04-07 |
| 1386973873 | Patty Denise Pena | Pharmacist | 1305 W County Rd, Odessa, TX 79763 | 2009-12-14 |
| 1508002262 | Javier E Espinoza | Physician Assistant | 1220 W. University, Odessa, TX 79763 | 2008-12-31 |
| 1952584690 | J A Mayans Md Pa | Ophthalmology | 907 W Second St, Odessa, TX 79763 | 2007-12-17 |
| Find all providers in zip 79763 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134473382 | Shanthi Thangam, Md Pa | Psychiatry & Neurology | 419 N Jackson Ave, Odessa, TX 79761-5124 | 2012-11-08 |
| 1366623803 | Roddy Strobel Mdpa | Psychiatry & Neurology | 3300 S. Fm 1788, Suite 403, Odessa, TX 79706 | 2007-11-26 |
| 1447352273 | Cheryl Ann Hollingsworth | Psychiatry & Neurology | 1111 W 12th St, Odessa, TX 79763-3596 | 2006-09-02 |
| 1265546378 | Lionel Levison | Psychiatry & Neurology | 4692 E University Blvd Ste 104, Odessa, TX 79762-6100 | 2006-08-18 |
| 1235157272 | Jose Francisco Del Moral | Psychiatry & Neurology | 4241 Tanglewood Ste 201, Odessa, TX 79762-5923 | 2006-07-17 |
| 1386621977 | Ravi Medi | Psychiatry & Neurology | 2626 Jbs Parkway Ste C 129, Odessa, TX 79761 | 2005-12-27 |
| 1215922802 | Shailesh Jain | Psychiatry & Neurology | 701 W 5th St Ste 2207, Odessa, TX 79763-4206 | 2005-09-20 |
| 1811555766 | Raafae Syed Agha | Psychiatry & Neurology | 701 W 5th St, Odessa, TX 79763-4206 | 2019-06-04 |
| 1639335607 | Mohammad K Chowdhury | Psychiatry & Neurology | 1278 W Us Highway 40, Odessa, MO 64076-9612 | 2008-07-30 |
| 1235286535 | Ravi Medi | Psychiatry & Neurology | 2626 John Ben Shepperd Pkwy, C-129, Odessa, TX 79761-1958 | 2007-01-05 |
| Find all providers in ODESSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.