Active NPI
W C Odonnell Jr MD PA
- Family Medicine Physician
- Kerrville, TX
National Provider Identifier
1649363573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- E3389
- Legal business name
- W C ODONNELL JR MD PA
- Practice address
- 708 Hill Country Dr
Building 300a
Kerrville, TX 78028-6079 - Phone
- (830) 257-5665
- Fax
- (830) 896-4434
- NPI assigned
- Oct 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. William Charles Odonnell Jr., MD
- Title
- Physician Owner
- Phone
- (830) 257-5665
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E3389 | TX | Primary |
Addresses
Primary practice location
708 Hill Country Dr
Building 300a
Kerrville, TX 78028-6079
Mailing address
708 Hill Country Dr
Building 300a
Kerrville, TX 78028-6079
Phone (830) 257-5665
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018QJ | Other | BLUE CROSS BLUE SHIELD | |
| 170958601 | Medicaid | TX | |
| A007 | Other | TX | HOH CARDIAC REHAB TRICARE |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214956800000",
"number": "1649363573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 HILL COUNTRY DR",
"address_2": "BUILDING 300A",
"city": "KERRVILLE",
"state": "TX",
"postal_code": "780286079",
"telephone_number": "830-257-5665",
"fax_number": "830-896-4434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 HILL COUNTRY DR",
"address_2": "BUILDING 300A",
"city": "KERRVILLE",
"state": "TX",
"postal_code": "780286079",
"telephone_number": "830-257-5665",
"fax_number": "830-896-4434"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "W C ODONNELL JR MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-02",
"last_updated": "2008-07-02",
"status": "A",
"authorized_official_last_name": "ODONNELL",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "CHARLES",
"authorized_official_title_or_position": "PHYSICIAN OWNER",
"authorized_official_telephone_number": "830-257-5665",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "TX",
"license": "E3389",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0018QJ",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "170958601",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOH CARDIAC REHAB TRICARE",
"identifier": "A007",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kerrville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.