MEDICARE: DR. EDWARD ALBERT ODOM PSYD

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	103TC0700X	Clinical Psychologist	40536	TX

General Provider Information

NPI Number	:	1790667681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD ALBERT ODOM PSYD

Provider Business Mailing Address
First Line	:	28210 PASEO DR # 190-255
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-5392
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28210 PASEO DR # 190-255
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-5392
Country	:	US
Telephone Number	:	813-438-4701
Fax Number	:

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

Provider Enumeration Date	:	07/22/2025
Last Update Date	:	07/22/2025

Similar Medicare Providers

1972448199 — MICHELLE AYSON APRN, FNP-BC
Practice Location Address:

28210 PASEO DR # 190210
WESLEY CHAPEL, FL
33543-5392

Practice Phone: 772-233-6822
Practice Fax:

1326623638 — MARISOL ARACELIS TORRES DNP, APRN, PMHNP-C
Practice Location Address:

28210 PASEO DR STE 190-259
WESLEY CHAPEL, FL
33543-5392

Practice Phone: 813-670-7723
Practice Fax: 813-336-8927

1700534021 — DR. VICTORIA JOHNSON PSY.D.
Practice Location Address:

28210 PASEO DR # 190-255
WESLEY CHAPEL, FL
33543-5392

Practice Phone: 813-438-4701
Practice Fax:

1801570726 — MARIPOSA PSYCHIATRY LLC
Practice Location Address:

28210 PASEO DR STE 190-259
WESLEY CHAPEL, FL
33543-5392

Practice Phone: 813-670-7023
Practice Fax: 813-336-8927

1457233512 — HAVEN PSYCHOLOGY, LLC
Practice Location Address:

28210 PASEO DR # 190-255
WESLEY CHAPEL, FL
33543-5392

Practice Phone: 813-438-4701
Practice Fax:

1518838481 — HALEY COTE
Practice Location Address:

28210 PASEO DR STE 258
WESLEY CHAPEL, FL
33543-5392

Practice Phone: 813-421-4089
Practice Fax:

Directions to “ DR. EDWARD ALBERT ODOM PSYD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.