Provider Demographics
NPI:1194118711
Name:OMEDEV PLLC
Entity type:Organization
Organization Name:OMEDEV PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASHIMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-878-5456
Mailing Address - Street 1:6624 N 10TH ST
Mailing Address - Street 2:SUITE NUMBER 'Q'
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3399
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6624 N 10TH ST
Practice Address - Street 2:SUITE NUMBER 'Q'
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3399
Practice Address - Country:US
Practice Address - Phone:956-878-5456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty