Basic Information
| Provider Information | |||||||||
| NPI: | 1578712311 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ODILI | ||||||||
| FirstName: | UZOCHUKWU | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 847408 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752847408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8325771491 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6501 S FRY RD | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774943376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322600670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2008 | ||||||||
| LastUpdateDate: | 09/23/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | N1027 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | N1027 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.