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JOHN DAVID ODOM M.D. NPI 1497118004


NPI Information

NPI: 1497118004
Provider Name: JOHN DAVID ODOM, M.D.
Classification: Medical Genetics - 207SG0202X
Entity Type: Individual

Specialization: Clinical Biochemical Genetics

PECOS Registration: Yes

Address:
333 N SANTA ROSA
SAN ANTONIO, TX
ZIP 78207
Phone: (713) 798-1750
Get Directions

John David Odom, M.D. is a clinical biochemical genetics medical genetics in San Antonio, TX with 8 years of experience. The provider is a clinical biochemical geneticist demonstrates competence in performing and interpreting biochemical analyses relevant to the diagnosis and management of human genetic diseases and is a consultant regarding laboratory diagnosis of a broad range of inherited disorders. John David Odom, M.D. NPI is 1497118004. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Graduation Year:2016

The provider's business location address is:

333 N SANTA ROSA
SAN ANTONIO, TX
ZIP 78207-108
Phone: (713) 798-1750
Fax: (713) 798-4693

The NPI 1497118004 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/31/2016 and was last updated on 2/23/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1170100000XMedical Genetics, Ph.D. Medical GeneticsS2861TEXASNo
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
3207SG0202XMedical GeneticsClinical Biochemical GeneticsS2861TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11497118004MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.