Provider Demographics
NPI:1427297134
Name:PERMIAN PHYSICIAN SERVICES
Entity type:Organization
Organization Name:PERMIAN PHYSICIAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:DYANE
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-464-2107
Mailing Address - Street 1:704 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3617
Mailing Address - Country:US
Mailing Address - Phone:432-523-6624
Mailing Address - Fax:432-524-1129
Practice Address - Street 1:704 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3617
Practice Address - Country:US
Practice Address - Phone:432-464-2377
Practice Address - Fax:432-464-2563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty