MEDICARE: GLORIA ODUM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	P9929	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336430818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA ODUM M.D.

Provider Business Mailing Address
First Line	:	1333 OLD SPANISH TRL STE G142
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1849
Country	:	US
Telephone Number	:	713-965-4480
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 NORFOLK ST STE 455
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4119
Country	:	US
Telephone Number	:	713-965-4480
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2011
Last Update Date	:	03/20/2026

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Directions to “ GLORIA ODUM M.D.” Practice Location

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