Individual provider Active NPI

Clara Ifeyinwa Odili, NP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1669217964
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1159620 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-3100
Fax
(817) 702-2140
NPI assigned
Jun 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1159620 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

200 W Magnolia Ave Ste 201
Fort Worth, TX 76104-7657
Phone (817) 702-1100

Other practice location 1

596 E Stacy Rd
Allen, TX 75002-8763
Phone (817) 726-6122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240724003007 TX Practitioner - Nurse Practitioner 6305382532 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

596 E Stacy Rd
Allen, TX 75002-8763
Phone (469) 898-0199

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1159620TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Doctors Express of the Beaumont Area PA CurrentSince May 16, 2024 Accepting new patients
Doctors Express of the Temple Area, PA PastSince May 16, 2024 Accepting new patients
Acclaim Physician Group, Inc PastSince Nov 20, 2017 Accepting new patients

Locations

596 E Stacy Rd
Allen, TX 75002
Phone (469) 898-0199

6600 S Mopac Expy
Ste 2180
Austin, TX 78749
Phone (512) 522-3010

8831 N Highway 146
Baytown, TX 77523
Phone (281) 533-8354

3195 Dowlen Rd
Ste 105
Beaumont, TX 77706
Phone (409) 860-1888

6340 N Eldridge Pkwy
Ste O
Houston, TX 77041
Phone (346) 385-9181

6445 FM 1463 Rd
Ste 230
Katy, TX 77494
Phone (281) 990-6890

8850 Spencer Hwy
La Porte, TX 77571
Phone (281) 946-9980

1921 W League City Pkwy
Ste 130
League City, TX 77573
Phone (281) 937-2590

4724 Lakeview Pkwy
Ste 300
Rowlett, TX 75088
Phone (469) 947-6240

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

Organizations & group practices 6

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": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1669217964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MAGNOLIA AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047657",
            "telephone_number": "817-702-1100",
            "fax_number": "817-702-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-3100",
            "fax_number": "817-702-2140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "596 E Stacy Rd",
            "address_purpose": "LOCATION",
            "city": "Allen",
            "state": "TX",
            "postal_code": "750028763",
            "country_code": "US",
            "telephone_number": "817-726-6122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODILI",
        "first_name": "CLARA",
        "middle_name": "IFEYINWA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1159620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.