Louise Anne Odom, P.T,

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1083277 Issued in TX

Practice address

1580 Highway 287 N
Mansfield, TX 76063-7593

Phone

(817) 473-4684

NPI assigned

Feb 19, 2008

Last updated

Feb 19, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Louise Anne Odom Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1629246079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 HIGHWAY 287 N",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637593",
            "telephone_number": "817-473-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 HIGHWAY 287 N",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637593",
            "telephone_number": "817-473-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "LOUISE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "P.T,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1083277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOUISE",
            "last_name": "ODOM",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.