MCH PROFESSIONAL CARE HOSPITAL BASED NPI 1447547773

NPI Information

NPI: 1447547773
Provider Name: MCH PROFESSIONAL CARE HOSPITAL BASED
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 45D0947685

Address:
500 W 4TH ST
ODESSA, TX
ZIP 79761
Phone: (432) 640-2401
Get Directions

MCH PROFESSIONAL CARE HOSPITAL BASED is a diagnostic radiology radiology in Odessa, TX. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MCH PROFESSIONAL CARE HOSPITAL BASED NPI is 1447547773. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

500 W 4TH ST
ODESSA, TX
ZIP 79761-001
Phone: (432) 640-2401
Fax: (432) 640-4606

The provider's authorized official is Adiel Alvarado .
The authorized official title is President and has the following contact phone number (432) 640-2401.

The CLIA number assigned to this NPI record is 45D0947685 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2011 and was last updated on 3/4/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207L00000X	Anesthesiology		No
2	207RC0200X	Internal Medicine	Critical Care Medicine	No
3	207ZP0102X	Pathology	Anatomic Pathology & Clinical Pathology	No
4	208M00000X	Hospitalist		No
5	2085R0202X	Radiology	Diagnostic Radiology	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	289541901	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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