MICHELLE GRUNDSTROM (NPI# 1538797311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538797311 |
| Entity Type | Individual |
| Full Name | MICHELLE GRUNDSTROM |
| Practice Address |
701 W 5th St Ste 1229 Odessa TX 79763-4206 |
| Practice Telephone | 4327035083 |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2020-03-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
701 W 5TH ST STE 1229 |
| City | ODESSA |
| State | TX |
| Zip Code | 79763-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245867092 | Cristian Alejandro Medina | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-03-23 |
| 1013525427 | Rangesh Mukundbhai Modi | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-07-22 |
| 1730797390 | Anosha Anwar | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-07-20 |
| 1407464068 | Karthik Chamarti | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-07-20 |
| 1598373144 | Muhammad Qudrat Ullah | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-07-20 |
| 1811519440 | Mustafa Hussain | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-05-18 |
| 1861021792 | Suna Burghul | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-04-02 |
| 1063040202 | Serin Thomas | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-04-01 |
| 1891323929 | Brandon Payne | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-04-01 |
| 1164050597 | Sharmin Hussain Nabi | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-03-31 |
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| 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 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982231569 | Yashica Patel | Student in an Organized Health Care Education/Training Program | 701 W. 5th St, Suite 1229, Odessa, TX 79763 | 2020-03-24 |
| 1245867092 | Cristian Alejandro Medina | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-03-23 |
| 1366901548 | Christopher Massengill | Student in an Organized Health Care Education/Training Program | 15319 Lake Maurine Dr, Odessa, FL 33556-3113 | 2019-03-18 |
| 1275091928 | Seychelle Baker | Student in an Organized Health Care Education/Training Program | 13707 Mill Pl, Odessa, FL 33556-4036 | 2019-03-12 |
| 1144740457 | Devi Priya Suravajjala | Student in an Organized Health Care Education/Training Program | 701,w 5th Street, Odessa, TX 79763 | 2017-06-27 |
| 1568075117 | Bibek Bakhati | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-08-24 |
| 1912517905 | Sailaja Devi Saragadam | Student in an Organized Health Care Education/Training Program | Texas Tech University Health Sciences Center, 701 West 5th Street, Odessa, TX 79763 | 2020-08-04 |
| 1013525427 | Rangesh Mukundbhai Modi | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-07-22 |
| 1811505274 | Hina Tariq | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-07-21 |
| 1730797390 | Anosha Anwar | Student in an Organized Health Care Education/Training Program | 701 W 5th St Ste 1229, Odessa, TX 79763-4206 | 2020-07-20 |
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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.