PERMIAN ER III (NPI# 1508255886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508255886 |
| Entity Type | Organization |
| Organization Name | PERMIAN ER III |
| Other Organization Name | EXCEL ER |
| Practice Address |
6131 East Highway 191 Odessa TX 79762 |
| Practice Telephone | 4363662911 |
| Mailing Telephone | 4363662911 |
| Mailing Fax Number | 4323660790 |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2016-06-13 |
| Authorized Official Name | CHRISTOPHER KWON (PRESIDENT) |
| Authorized Official Telephone | 4363662911 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TDSHS FEC LICENSE | 160257 | 01 |
| Other Name | Type Code |
|---|---|
| Excel ER | Doing Business As Name - Organization |
| Street Address |
6131 EAST HIGHWAY 191 |
| City | ODESSA |
| State | TX |
| Zip Code | 79762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982256798 | Winwood Dental and Orthodontics Pllc | Dentist | 3913 E 42nd Street, Odessa, TX 79762 | 2019-07-11 |
| 1265995716 | Ryan Daniels | Specialist/Technologist | 4901 E University, Gym 111, Odessa, TX 79762 | 2019-04-11 |
| 1215429592 | Michael Wayne Samp | Respiratory Therapist, Registered | 2807 Windsor Dr, Odessa, TX 79762 | 2018-06-03 |
| 1972003663 | Kristi Young | Registered Nurse | 3800 E. 42nd St., Suite 203 Attn: Pediatric Dept, Odessa, TX 79762 | 2018-02-19 |
| 1427508902 | Whitney Diakur | Optometrist | 5011 E. 42nd St, Odessa, TX 79762 | 2016-10-10 |
| 1295184927 | Farqad Kamal Abuoudeh | Dentist | 6109 Tx-191 Frontage, Odessa, TX 79762 | 2016-06-03 |
| 1457714180 | Daniel & Max, LLC | Optometrist | 5011 E. 42nd Street, Odessa, TX 79762 | 2016-03-31 |
| 1407225774 | Neri Campos-gardea | Massage Therapist | 3952 E 42d, Odessa, TX 79762 | 2015-09-17 |
| 1548675861 | Tina Desai | Dentist | 6109 Texas 191, Odessa, TX 79762 | 2014-06-25 |
| 1932534336 | Gavyn Thomas | Pharmacist | 4513 Esmond Drive, Apt 509, Odessa, TX 79762 | 2013-09-05 |
| Find all providers in zip 79762 | ||||
| Taxonomy Code | 261QE0002X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Emergency Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720535800 | West Texas Excel Er Physicians, Pllc | Clinic/Center | 6131 E Highway 191, Odessa, TX 79762-5348 | 2016-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568079564 | Montrose Er LLC | Clinic/Center | 1110 W Gray St Ste 201, Houston, TX 77019-4133 | 2020-09-24 |
| 1609481712 | Montrose Er LLC | Clinic/Center | 1110 W Gray St, Houston, TX 77019-4133 | 2020-09-15 |
| 1932713666 | Tecc Atascocita LLC | Clinic/Center | 19143 W Lake Houston Pkwy, Humble, TX 77346-4800 | 2020-09-01 |
| 1265046908 | Tecc Pearland LLC | Clinic/Center | 3115 Dixie Farm Rd Ste 107, Pearland, TX 77581-5923 | 2020-09-01 |
| 1366056194 | Er of Texas Little Elm LLC | Clinic/Center | 2800 Little Elm Pkwy, Little Elm, TX 75068-6650 | 2020-08-31 |
| 1740892801 | Satx Emergency Physicians Pllc | Clinic/Center | 8721 Menchaca Rd, Austin, TX 78748-5308 | 2020-08-20 |
| 1568098119 | Complete Temple Fser Facility LLC | Clinic/Center | 1551 W Central Ave, Temple, TX 76504-4005 | 2020-03-16 |
| 1770118879 | Exceptional Healthcare Tyler LLC | Clinic/Center | 2222 E Southeast Loop 323, Tyler, TX 75701-8320 | 2020-03-09 |
| 1841838901 | Cross Care of North Texas LLC | Clinic/Center | 2401 Willow Oak Dr, Irving, TX 75060-6965 | 2019-12-19 |
| 1255978722 | Medco Er Carrollton, LLC | Clinic/Center | 2745 E Belt Line Rd, Carrollton, TX 75006-5436 | 2019-12-04 |
| Find all providers with the same taxonomy | ||||
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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.