Individual provider Active NPI

Evelyn Anne Atieno Odawo, M.D

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1497001549
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S8353 Issued in TX
Practice address
8121 Broadway St Ste 150
Houston, TX 77061-1342
Phone
(832) 709-2770
Fax
(832) 924-0113
NPI assigned
Jul 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S8353 TX Primary

Addresses

Primary practice location

8121 Broadway St Ste 150
Houston, TX 77061-1342

Mailing address

8121 Broadway St Ste 150
Houston, TX 77061-1342
Phone (832) 709-2770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210217001334 TX Practitioner - Internal Medicine 4981851987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Physicians Group of Texas PLLC Internal Medicine CurrentSince Apr 1, 2021 Accepting new patients
Dedicated Physicians Group of Texas, PLLC CurrentSince Apr 1, 2021 Accepting new patients
Christiana Medical Group, PA Past Accepting new patients
Bayhealth Hospitalist, LLC Past Accepting new patients

Locations

8121 Broadway St
Ste 150
Houston, TX 77061
Phone (832) 709-2770

8471 Gulf Fwy
Houston, TX 77017
Phone (314) 390-5433

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1497001549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 BROADWAY ST STE 150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770611342",
            "telephone_number": "832-709-2770",
            "fax_number": "832-924-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 BROADWAY ST STE 150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770611342",
            "telephone_number": "832-709-2770",
            "fax_number": "832-924-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODAWO",
        "first_name": "EVELYN",
        "middle_name": "ANNE ATIENO",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S8353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.