| Organization Name: | WEST TEXAS DIABETES AND ENDOCRINE CENTER PA |
| NPI Number: | 1891900080 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MURALIDHAR AGUSALA (ADMINISTRATOR) |
| Mailing Address: | 318 N Alleghaney Ave Ste 201 Odessa |
| State: | TX US |
| Postal Code: | 797615027 |
| Phone Number: | 4323321144 |
| Fax Number: | 4323372726 |
| NPI Enumeration Date: | 05/11/2007 |
| NPI Last Update Date: | 01/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | K6230 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |