Provider Demographics
NPI:1700482726
Name:ODILI, OZIOMA IVANA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OZIOMA
Middle Name:IVANA
Last Name:ODILI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11031 CROFTMORE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2914
Mailing Address - Country:US
Mailing Address - Phone:713-261-6714
Mailing Address - Fax:
Practice Address - Street 1:1853 W 2ND ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:TX
Practice Address - Zip Code:77541-4613
Practice Address - Country:US
Practice Address - Phone:979-233-5415
Practice Address - Fax:979-223-0298
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist