Susan Gero Odak

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F07211228 Issued in TX

Practice address

7726 Shavano LN
Cypress, TX 77433-6706

Phone

(763) 742-3252

NPI assigned

Jul 22, 2021

Last updated

Jul 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1922671353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7726 SHAVANO LN",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774336706",
            "telephone_number": "763-742-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7726 SHAVANO LN",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774336706",
            "telephone_number": "763-742-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODAK",
        "first_name": "SUSAN",
        "middle_name": "GERO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F07211228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Cypress, TX
• Providers in Cypress, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.