Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | S7316 | TX |
N | 2080P0210X | Pediatric Nephrologist | S7316 | TX |
NPI | 1447674858 |
---|---|
Provider Name | Atul Poudel |
First Address | Odessa, TX 79763-4601 |
Second Address | Odessa, TX 79763-4601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2014 |
Last Update Date | 15/09/2020 |