Charles A Lively Md Pa

LBN: Charles A Lively Md Pa
Charles A Lively Md Pa is an health care organization with primary practice located at 608 N Muskingum Ave , Odessa TX 79761-4539. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics, which is considered as the primary health care specialty. Charles A Lively Md Pa can be contacted via phone (432) 580-9168, or through Lively, Charles A via phone (432) 580-9168.

Contact Information

Primary practice address
608 N Muskingum Ave Odessa TX 79761-4539
Phone: (432) 580-9168
Fax: (432) 580-8221
Website:
Map and Directions
Authorized official contact:
Name: Lively, Charles A Doctor of Medicine (MD)
Phone: (432) 580-9168

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X H6384 Texas

Profile Details

NPI number 1437363926
LBN Legal business name Charles A Lively Md Pa
DBA Doing business as
Authorized official Lively, Charles A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 10th, 2007
Last updated Mar 7th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437363926 NPPES
Texas MEDICAID 123169807
Texas Other H6384
Texas Other 50072573

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