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General NPI Number Information
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NPI Number | 1144274234
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Entity Type | Individual
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Provider Name | LEROY ODOM MD
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Gender | Male
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Dates
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Enumeration Date | 05/21/2006
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 2101 CRAWFORD ST STE 300
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City | HOUSTON
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State | TX
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Zip | 77002-8941
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Country | US
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Telephone | 713-658-8660
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Fax | 713-658-0205
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Provider Business Mailing Address
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Address Line | 2101 CRAWFORD SUITE 300
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City | HOUSTON
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State | TX
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Zip | 77002-9014
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Country | US
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Telephone | 713-658-8660
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Fax | 713-658-0205
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | F6295
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License Number State | TX
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