MEDICARE: JUDY ODOGWU RN

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	163W00000X	Registered Nurse	1167907	TX
2	163WH0200X	Home Health Registered Nurse	1167907	TX

General Provider Information

NPI Number	:	1376499053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY ODOGWU RN

Provider Business Mailing Address
First Line	:	8127 PERALTA VALLEY CT
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1888
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8127 PERALTA VALLEY CT
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1888
Country	:	US
Telephone Number	:	307-371-5099
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/10/2026

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