Dickson O Odero, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

F3265 Issued in TX

Practice address

10 Medical Center Blvd
A
Lufkin, TX 75904-3173

Phone

(936) 632-4282

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ambeaux Professional MGMT Ser LLC

  • Family Medicine Physician
  • Livingston, TX
  • NPI 1699751180
  NPD (past)
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585
  NPD (past)
• Texas Institute for Kidney and Endocrine Disorders, PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Lufkin, TX
  • NPI 1295915338
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515801600000",
    "number": "1972655652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153701",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759153701",
            "telephone_number": "936-632-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEDICAL CENTER BLVD",
            "address_2": "A",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043173",
            "telephone_number": "936-632-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODERO",
        "first_name": "DICKSON",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2018-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "F3265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI CARE",
            "identifier": "742080151759040000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00ET90",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114579901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Occucare, LTD.
• Oceans Behavioral Hospital of Lufkin, LLC
• Chikezie John Ochieze, M.D.
• Florence Ndubuisi Ochieze, PMHNP
• Michael Odell, PA-C
• James D Odom, RN CPNP
• Crystal Odoms
• Egberanmwen Okundaye, MD
• Olufemi Taiwo Oladele-Ajose, MD
• Danielle Marie Olague, RBT

• All providers in Lufkin, TX
• Infectious Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.