Individual
JOHN DAVID ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(713) 798-1750
(713) 798-4693
Mailing address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(713) 798-1750
(713) 798-4693
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
S2861
TX
207SG0202X
Clinical Biochemical Genetics Physician
Primary
S2861
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497118004
—
MD
Enumeration date
03/31/2016
Last updated
02/23/2023
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