Healthcare Provider Details

I. General information

NPI: 1669744298
Provider Name (Legal Business Name): PERMIAN DIAGNOSTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 RACQUET CLUB DR
MIDLAND TX
79705-7432
US

IV. Provider business mailing address

2701 RACQUET CLUB DR
MIDLAND TX
79705-7432
US

V. Phone/Fax

Practice location:
  • Phone: 281-970-5900
  • Fax: 281-970-5913
Mailing address:
  • Phone: 281-970-5900
  • Fax: 281-970-5913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL RAMSEY
Title or Position: MANAGER
Credential: M.D
Phone: 281-970-5900