Provider Demographics
NPI:1497001549
Name:ODAWO, EVELYN ANNE ATIENO (MD)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:ANNE ATIENO
Last Name:ODAWO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8121 BROADWAY ST STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77061-1342
Mailing Address - Country:US
Mailing Address - Phone:832-709-2770
Mailing Address - Fax:832-924-0113
Practice Address - Street 1:8121 BROADWAY ST STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77061-1342
Practice Address - Country:US
Practice Address - Phone:832-709-2770
Practice Address - Fax:832-924-0113
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS8353207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine