Provider Demographics
NPI:1083235691
Name:ODO, ANNEMARIE OSONDU (NP)
Entity Type:Individual
Prefix:DR
First Name:ANNEMARIE
Middle Name:OSONDU
Last Name:ODO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 LAKE MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2718
Mailing Address - Country:US
Mailing Address - Phone:469-569-3534
Mailing Address - Fax:
Practice Address - Street 1:9450 SKILLMAN ST STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8235
Practice Address - Country:US
Practice Address - Phone:469-569-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145857363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health