DR. JOSEPH BOTTALICO (NPI# 1538130653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538130653 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH BOTTALICO |
| Credential | D.O. |
| Practice Address |
420 E 6th St Suite 202 Odessa TX 79761-4529 |
| Mailing Address |
Po Box 4123 Odessa TX 79760-4123 |
| Practice Telephone | 4325828757 |
| Practice Fax Number | 4325828928 |
| Mailing Telephone | 4325822277 |
| Mailing Fax Number | 4323332802 |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2016-01-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | OS005732L | PA | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | MB04176800 | NJ | Allopathic & Osteopathic Physicians |
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
P1969 | TX | Allopathic & Osteopathic Physicians |
| N | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
MB04176800 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 8895NO | 05 | |
| NJ | 2099101 | 05 |
| Street Address |
420 E 6TH ST SUITE 202 |
| City | ODESSA |
| State | TX |
| Zip Code | 79761-4529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952308934 | Vinh H. Nguyen | Internal Medicine | 420 E 6th St, Suite 200, Odessa, TX 79761-4529 | 2005-07-05 |
| 1356714406 | Elena Krendelshchikova | Nurse Practitioner | 420 E 6th St, Suite 107, Odessa, TX 79761-4529 | 2015-11-10 |
| 1609274034 | Mary Elise Seigler | Nurse Practitioner | 420 E 6th St, Suite 202, Odessa, TX 79761-4529 | 2014-12-17 |
| 1992127195 | Arrhythmia Consultants of Texas Pa | Internal Medicine | 420 E 6th St, Suite 201b, Odessa, TX 79761-4529 | 2014-01-08 |
| 1477874790 | Vinh Nguyen, Md, Pa | Pediatrics | 420 E 6th St, Suite 200, Odessa, TX 79761-4529 | 2010-06-22 |
| 1376729004 | Odessa Consultants, LLC | Clinic/Center | 420 E 6th St, Suite 107, Odessa, TX 79761-4529 | 2008-01-11 |
| 1285794289 | Ram Kolluru,m.d.pa | Internal Medicine | 420 E 6th St, Ste 102, Odessa, TX 79761-4529 | 2006-12-11 |
| 1174532386 | Anjaiah Kodityal | Internal Medicine | 420 E 6th St, Suite 205, Odessa, TX 79761-4529 | 2006-08-05 |
| 1275572679 | Nancy L Eriksen | Obstetrics & Gynecology | 420 E 6th St, Suite 202, Odessa, TX 79761-4529 | 2006-06-04 |
| 1699743187 | Madhu Pamganamamula | Internal Medicine | 420 E 6th St, Suite 107, Odessa, TX 79761-4529 | 2006-03-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482003 | Endovascular Lab Pllc | Surgery | 612 N Washington Avenue, Suite 100, Odessa, TX 79761 | 2020-03-16 |
| 1235627605 | Megan Elizabeth Lemond | Pediatrics | 912 E 5th St, Odessa, TX 79761 | 2018-05-01 |
| 1922522630 | Brian W Griffin | Nurse Practitioner | 4606 Fountain Ln., Odessa, TX 79761 | 2017-08-03 |
| 1023540507 | Florenda De Guzman | Nurse Practitioner | 405 N Tom Green, Odessa, TX 79761 | 2017-04-03 |
| 1205378239 | Scotty R Ortega Md | Clinical Nurse Specialist | 2487 E 11th Street, Odessa, TX 79761 | 2016-11-08 |
| 1487094355 | Marivel Perez | Nurse Practitioner | 540 W 5th St Ste 350, Ste. 350, Odessa, TX 79761 | 2013-06-25 |
| 1245579804 | Accurate Health Care LLC | Home Health | 302 Industrial Ave, Odessa, TX 79761 | 2013-02-01 |
| 1437421666 | Mary Magdalene Garcia | Speech-Language Pathologist | 620 N. Alleghaney, Odessa, TX 79761 | 2012-02-03 |
| 1841576378 | Ashley Burdex | Family Medicine | 6030 W University, Odessa, TX 79761 | 2011-10-28 |
| 1730465428 | Therese A Archer | Massage Therapist | 712 N. Texas Ave, Odessa, TX 79761 | 2011-10-26 |
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| Taxonomy Code | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851367346 | Louis E Ridgway IIi | Obstetrics & Gynecology | 2817 Jbs Pkwy, Suite A-103, Odessa, TX 79762-8111 | 2006-02-24 |
| 1659376937 | Joseph P Bruner | Obstetrics & Gynecology | 420 E 6th St Ste 202, Odessa, TX 79761-4572 | 2005-06-14 |
| 1730519331 | West Texas Maternal Fetal Medicine Center, LLC | Obstetrics & Gynecology | 810 N Dixie Blvd, Suite 109, Odessa, TX 79761-2803 | 2013-11-18 |
| 1689608101 | Byron D. Elliott | Obstetrics & Gynecology | 420 E 6th St Ste 202, Odessa, TX 79761-4572 | 2006-07-10 |
| 1083656938 | Jorge D Blanco | Obstetrics & Gynecology | 420 E 6th St Ste 202, Odessa, TX 79761-4572 | 2006-06-12 |
| 1275572679 | Nancy L Eriksen | Obstetrics & Gynecology | 420 E 6th St, Suite 202, Odessa, TX 79761-4529 | 2006-06-04 |
| 1396717211 | James E Maher IIi | Obstetrics & Gynecology | 701 W 5th St, Suite 3212, Odessa, TX 79763-4206 | 2006-02-03 |
| 1851374946 | Randall Kelly | Obstetrics & Gynecology | 701 W 5th St, Odessa, TX 79763-4206 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990261 | Melissa Ann Cassady | Obstetrics & Gynecology | 6500 N Mo Pac Expy Ste 1205, Austin, TX 78731-3282 | 2020-10-19 |
| 1619433034 | Mariposa Perinatal Services Pllc | Obstetrics & Gynecology | 1510 W. Hwy 287 Bypass, Ste. 100, Waxahachie, TX 75165 | 2019-02-11 |
| 1558875898 | Texas Perinatology | Obstetrics & Gynecology | 413 Jackson Hill St, Houston, TX 77007-7409 | 2017-11-23 |
| 1699227298 | Perinatology and Genetics Pllc | Obstetrics & Gynecology | 6701 Heritage Pkwy Ste 145, Rockwall, TX 75087-8724 | 2016-10-30 |
| 1437501988 | Nima Goharkhay, Pllc | Obstetrics & Gynecology | 1016 Point Isabel Ln, Friendswood, TX 77546-7896 | 2016-07-08 |
| 1578939435 | Magdalena Sanz Cortes | Obstetrics & Gynecology | 6651 Main St., Texas Childrens Hospital Pavillion for Women.mfm Divisi, Houston, TX 77030 | 2015-08-14 |
| 1417357211 | Robert Patterson | Obstetrics & Gynecology | 3205 Pickwick Ln, Rollingwood, TX 78746-5516 | 2014-08-28 |
| 1134548399 | Mary Micaela Rieger | Obstetrics & Gynecology | 1313 Red River St Ste A1, Austin, TX 78701-1907 | 2014-04-15 |
| 1922447648 | John Byrne | Obstetrics & Gynecology | 315 N San Saba Ste 930, San Antonio, TX 78207-3154 | 2013-06-15 |
| 1083969299 | Caroline Marrs | Obstetrics & Gynecology | 7777 Forest Ln Ste 565, Dallas, TX 75230 | 2012-07-13 |
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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.