Odom, Charles A

Odom, Charles A is an individual health care provider with primary practice located at 10700 Mcpherson Ave , Laredo TX 78045-6268. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Odom, Charles A can be contacted via phone (956) 523-2619.

Contact Information

Primary practice address
10700 Mcpherson Ave Laredo TX 78045-6268
Phone: (956) 523-2619
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 221707 Texas

Profile Details

NPI number 1407827108
LBN Legal business name Odom, Charles A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407827108 NPPES
Texas Other 84078U BCBS
Texas Other P00129710 BCBS

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