Individual
RAVEN ODOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
280 HIGHWAY 418 E, SILSBEE, TX 77656-3729
(409) 386-1200
(409) 386-1219
Mailing address
280 HIGHWAY 418 E, SILSBEE, TX 77656-3729
(409) 386-1200
(409) 386-1219
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
92475
TX
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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