GUSTAVO S ODERICH MD NPI 1740254515

NPI Information

NPI: 1740254515
Provider Name: GUSTAVO S ODERICH, MD
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
6400 FANNIN ST STE 2850
HOUSTON, TX
ZIP 77030
Phone: (713) 486-5139
Get Directions

Gustavo S Oderich, MD is a vascular surgery surgery in Houston, TX with 29 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Gustavo S Oderich, MD NPI is 1740254515. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6400 FANNIN ST STE 2850
HOUSTON, TX
ZIP 77030-540
Phone: (713) 486-5139
Fax: (713) 512-7203

The NPI 1740254515 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 2/16/2006 and was last updated on 12/14/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	43750	MINNESOTA	No
2	2086S0129X	Surgery	Vascular Surgery	ME143785	FLORIDA	No
3	2086S0129X	Surgery	Vascular Surgery	41799	ARIZONA	No
4	2086S0129X	Surgery	Vascular Surgery	S8221	TEXAS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	412608803	MEDICAID	TEXAS
2	412608804	OTHER	TEXAS	CSHCN

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

NPI Synchronization or Removal

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.

« Previous NPI

Next NPI »