Healthcare Provider Details

I. General information

NPI: 1285449488
Provider Name (Legal Business Name): SUMERA ODHWANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24802 ALDINE WESTFIELD RD
SPRING TX
77373-5926
US

IV. Provider business mailing address

2741 ALTISSIMO CT
SPRING TX
77386-4964
US

V. Phone/Fax

Practice location:
  • Phone: 281-288-1561
  • Fax:
Mailing address:
  • Phone: 832-876-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70901
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: