Provider Demographics
NPI:1790012946
Name:ODIA, JILL GENISE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:GENISE
Last Name:ODIA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 WESTHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5006
Mailing Address - Country:US
Mailing Address - Phone:713-629-0703
Mailing Address - Fax:713-629-6061
Practice Address - Street 1:3900 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5006
Practice Address - Country:US
Practice Address - Phone:713-629-0703
Practice Address - Fax:713-629-6061
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist