Physician Compare National (NPI:1669449617)

HEALTHCARE PROVIDER: KHAVAR J DAR MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1669449617
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1355251489
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080603000812
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DAR
	Individual professional last name
Provider First Name	KHAVAR
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	PULMONARY DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CRITICAL CARE (INTENSIVISTS)
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	INTERNAL MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CRITICAL CARE (INTENSIVISTS), INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	ODESSA MEDICAL ENTERPRISES PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8022188960
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	420 E 6TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 201B
	Group Practice or individual's line 2 address
City	ODESSA
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	797614572
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4323325557
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450661
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ODESSA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450132
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEDICAL CENTER HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450144
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	PERMIAN REGIONAL MEDICAL CENTER ANDREWS COUNTY HO
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	451353
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	CRANE COUNTY HOSPITAL DISTRICT
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	M