Individual
RAYMOND C ODIAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
7272 WURZBACH RD STE 601, SAN ANTONIO, TX 78240-4803
(210) 615-3483
Mailing address
4015 HAWTHORNE DR, SACHSE, TX 75048-4087
(972) 804-3712
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1018584
TX
Other
Enumeration date
11/11/2020
Last updated
11/12/2020
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