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Organization
W C ODONNELL JR MD PA
Active
Organization
W C ODONNELL JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM CHARLES ODONNELL JR. MD (PHYSICIAN OWNER)
(830) 257-5665
Entity
Organization
Contact information
Practice address
708 HILL COUNTRY DR, BUILDING 300A, KERRVILLE, TX 78028-6079
(830) 257-5665
(830) 896-4434
Mailing address
708 HILL COUNTRY DR, BUILDING 300A, KERRVILLE, TX 78028-6079
(830) 257-5665
(830) 896-4434
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E3389
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018QJ
BLUE CROSS BLUE SHIELD
—
05
—
170958601
—
TX
01
—
A007
HOH CARDIAC REHAB TRICARE
TX
Enumeration date
10/02/2006
Last updated
07/02/2008
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