MEDICARE: UGOCHUKWU ODO

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	207RH0003X	Hematology & Oncology Physician	R6067	TX
2	207R00000X	Internal Medicine Physician	BP10044203	TX
3	207RH0003X	Hematology & Oncology Physician	04-50732	KS

General Provider Information

NPI Number	:	1215282694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UGOCHUKWU ODO

Provider Business Mailing Address
First Line	:	2000 PINE ST
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79601-2434
Country	:	US
Telephone Number	:	325-670-6340
Fax Number	:	325-670-6174

Provider Business Practice Location Address
First Line	:	1655 E CACTUS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7722
Country	:	US
Telephone Number	:	702-781-9100
Fax Number	:

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

Provider Enumeration Date	:	07/20/2012
Last Update Date	:	11/17/2025

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