CHARLES A LIVELY MD PA (NPI# 1437363926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437363926 |
| Entity Type | Organization |
| Organization Name | CHARLES A LIVELY MD PA |
| Practice Address |
608 N Muskingum Ave Odessa TX 79761-4539 |
| Practice Telephone | 4325809168 |
| Practice Fax Number | 4325808221 |
| Mailing Telephone | 4325809168 |
| Mailing Fax Number | 4325808221 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2010-06-01 |
| Authorized Official Name | DR. CHARLES A LIVELY (OWNER PHYSICIAN) |
| Authorized Official Telephone | 4325809168 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
H6384 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 123169807 | 05 | |
| TX | DEA | BL2122567 | 01 |
| TX | H6384 | H6384 | 01 |
| TX | DPS | 50072573 | 01 |
| Street Address |
608 N MUSKINGUM AVE |
| City | ODESSA |
| State | TX |
| Zip Code | 79761-4539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326062589 | Charles Auborn Lively | Obstetrics & Gynecology | 608 N Muskingum Ave, Odessa, TX 79761-4539 | 2006-07-27 |
| 1033589502 | Cryselda Ann Russell | Nurse Practitioner | 608 N Muskingum Ave, Odessa, TX 79761-4539 | 2015-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482003 | Endovascular Lab Pllc | Surgery | 612 N Washington Avenue, Suite 100, Odessa, TX 79761 | 2020-03-16 |
| 1235627605 | Megan Elizabeth Lemond | Pediatrics | 912 E 5th St, Odessa, TX 79761 | 2018-05-01 |
| 1922522630 | Brian W Griffin | Nurse Practitioner | 4606 Fountain Ln., Odessa, TX 79761 | 2017-08-03 |
| 1023540507 | Florenda De Guzman | Nurse Practitioner | 405 N Tom Green, Odessa, TX 79761 | 2017-04-03 |
| 1205378239 | Scotty R Ortega Md | Clinical Nurse Specialist | 2487 E 11th Street, Odessa, TX 79761 | 2016-11-08 |
| 1487094355 | Marivel Perez | Nurse Practitioner | 540 W 5th St Ste 350, Ste. 350, Odessa, TX 79761 | 2013-06-25 |
| 1245579804 | Accurate Health Care LLC | Home Health | 302 Industrial Ave, Odessa, TX 79761 | 2013-02-01 |
| 1437421666 | Mary Magdalene Garcia | Speech-Language Pathologist | 620 N. Alleghaney, Odessa, TX 79761 | 2012-02-03 |
| 1841576378 | Ashley Burdex | Family Medicine | 6030 W University, Odessa, TX 79761 | 2011-10-28 |
| 1730465428 | Therese A Archer | Massage Therapist | 712 N. Texas Ave, Odessa, TX 79761 | 2011-10-26 |
| Find all providers in zip 79761 | ||||
| Taxonomy Code | 207VX0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Obstetrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104437367 | Jodi M Brannen Md Pllc | Obstetrics & Gynecology | 519 N King St Ste 101, Seguin, TX 78155-4859 | 2020-08-12 |
| 1588151989 | Sara Maria Moufarrij | Obstetrics & Gynecology | One Baylor Plaza, Bcm610 Houston, Tx 77030, Houston, TX 77030 | 2018-04-20 |
| 1164935359 | Stephanie Gotcher | Obstetrics & Gynecology | 19740 I- 45 North, Spring, TX 77373 | 2017-11-09 |
| 1821549726 | Alexander Golab | Obstetrics & Gynecology | 23914 Ladera Rnch, San Antonio, TX 78261-2816 | 2016-10-17 |
| 1659735827 | Anibal Mikjail Avila | Obstetrics & Gynecology | 2821 Michaelangelo, Suite 400, Edinburg, TX 78539 | 2016-04-13 |
| 1861879447 | Laura Fonseca | Obstetrics & Gynecology | 4217 North Mccoll Rd Ste 700, Mcallen, TX 78504-4466 | 2015-05-02 |
| 1871833301 | Jeff E Hagen Md | Obstetrics & Gynecology | 18810 Hwy 290 E, Suite 100, Elgin, TX 78621-4240 | 2013-02-20 |
| 1124377486 | Chidera Catherine Ejiogu | Obstetrics & Gynecology | 7777 Southwest Fwy Ste 454, Houston, TX 77074-1816 | 2012-09-02 |
| 1659626778 | Meghan Mcginnis | Obstetrics & Gynecology | 6431 Fannin St Ste 3.214, Houston, TX 77030-1501 | 2012-07-14 |
| 1780902809 | Zachary Thomas Ripp | Obstetrics & Gynecology | 2959 S. Buckner Ste 100, Mi Doctor/ Women's Specialty Center, Dallas, TX 75227 | 2010-05-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CHARLES A LIVELY MD PA.
| 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.