MEDICARE: MS. JO ODELL PENA

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		TX

General Provider Information

NPI Number	:	1528927100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JO ODELL PENA

Provider Business Mailing Address
First Line	:	2605 ESPERANZA LN
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-6230
Country	:	US
Telephone Number	:	956-490-5802
Fax Number	:

Provider Business Practice Location Address
First Line	:	2605 ESPERANZA LN
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-6230
Country	:	US
Telephone Number	:	956-490-5802
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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