Individual
LOLITA ALANNA ODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 SW 36TH ST, SAN ANTONIO, TX 78237-3360
(210) 358-5100
Mailing address
PO BOX 734812, DALLAS, TX 75373-4812
(210) 358-9500
(210) 358-9183
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP142785
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP142785
TX
Other
Enumeration date
03/10/2020
Last updated
05/20/2024
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