LISA GAILE ODOM (NPI# 1992988539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992988539 |
| Entity Type | Individual |
| Full Name | LISA GAILE ODOM |
| Credential | APRN-BC |
| Practice Address |
1353 N Travis St Liberty TX 77575-3549 |
| Mailing Address |
4120 Burning Tree Dr Kettering OH 45440-1112 |
| Practice Telephone | 9363367316 |
| Practice Fax Number | 9363362280 |
| Mailing Telephone | 7132401775 |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
658834 | TX | Nursing Service Providers |
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
658834 | TX | Nursing Service Providers |
| N | 163WF0300X |
Registered Nurse Specialization: Flight |
658834 | TX | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
658834 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SE0003X |
Clinical Nurse Specialist Specialization: Emergency |
658834 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123566 | Lisa Kincaid Odom | Pharmacist | 218 Woodland Hills Dr, Oxford, MS 38655-9770 | 2020-10-27 |
| 1598007668 | Lisa Nicole Odom | Pediatrics | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2013-03-26 |
| 1801108345 | Lisa Nichole Odom | Counselor | 2120 Alpine Blvd., 2120 Alpine Boulevard, Alpine, CA 91901 | 2010-07-13 |
| Street Address |
1353 N TRAVIS ST |
| City | LIBERTY |
| State | TX |
| Zip Code | 77575-3549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114945532 | Danny Kyaw Khine | Internal Medicine | 1353 N Travis St, Liberty, TX 77575-3549 | 2006-07-17 |
| 1679926992 | Liberty County Hospital District No 1 | Clinic/Center | 1353 N Travis St, Liberty, TX 77575-3549 | 2016-07-21 |
| 1811371701 | Liberty County Hospital District No. 1 | Medicare Defined Swing Bed Unit | 1353 N Travis St, Liberty, TX 77575-3549 | 2015-07-10 |
| 1770964991 | Susan D. Clark | Nurse Practitioner | 1353 N Travis St, Liberty, TX 77575-3549 | 2015-06-12 |
| 1295128247 | Ess of South Texas LLC | Emergency Medicine | 1353 N Travis St, Liberty, TX 77575-3549 | 2015-03-16 |
| 1922328335 | Israel Tegegne Haile | Internal Medicine | 1353 N Travis St, Liberty, TX 77575-3549 | 2010-06-08 |
| 1487889960 | Heather Reed | Physician Assistant | 1353 N Travis St, Liberty, TX 77575-3549 | 2009-05-27 |
| 1407094667 | Shelly Margaret States | Physician Assistant | 1353 N Travis St, Liberty, TX 77575-3549 | 2009-01-27 |
| 1770733081 | Liberty Dayton Community Hospital | General Acute Care Hospital | 1353 N Travis St, Liberty, TX 77575-3549 | 2008-09-23 |
| 1740344415 | Steven Wayne Branham | Nurse Practitioner | 1353 N Travis St, Liberty, TX 77575-3549 | 2006-12-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750981502 | Parikshit Jayant Davda | Clinic/Center | 1620 Magbolia Street, Liberty, TX 77575 | 2020-10-30 |
| 1003285156 | Divine Garden Transportation | Non-emergency Medical Transport (VAN) | 450 Mlking Dr., Liberty, TX 77575 | 2015-09-18 |
| 1689895799 | Allen R. Griffin | Eyewear Supplier (Equipment, not the service) | 2718 B N. Main St., Liberty, TX 77575 | 2007-05-02 |
| 1548362395 | Hsmtx/liberty, LLC | Skilled Nursing Facility | 1206 N Travis St, Liberty, TX 77575 | 2006-09-02 |
| 1699877530 | Lessie Frank | Licensed Vocational Nurse | 612 Highway 90, Liberty, TX 77575 | 2006-09-01 |
| 1588601827 | Trudy Poor Britz | Nurse Practitioner | 1807 Rampart, League, TX 77575 | 2006-06-02 |
| 1285680033 | Faresh Mehta | Optometrist | 2121 Hwy 146 Bypass, Liberty, TX 77575 | 2006-05-25 |
| 1922455781 | Bassam A. Hamid M.d.,p.a. Urgent Care/primarycare | Clinic/Center | 608 Travis, Liberty, TX 77575 | 2016-05-20 |
| 1508887241 | Tri-county Behavioral Healthcare | Intermediate Care Facility, Mentally Retarded | 1420 Holly St, Liberty, TX 77575-3118 | 2006-07-21 |
| 1528581220 | D&s Residential Services, Lp | Intermediate Care Facility, Mentally Retarded | 1420 Holly St, Liberty, TX 77575-3118 | 2017-07-25 |
| Find all providers in zip 77575 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225653306 | Ashley Pence Wilson | Nurse Practitioner | 1105 Jackson Ct, Liberty, MO 64068-3372 | 2020-06-14 |
| 1417503186 | Susan Mwirigi Gunn | Nurse Practitioner | 1021 Bob White Ln, Liberty, MO 64068-7427 | 2019-08-17 |
| 1063935062 | Jennifer Nichole Gibson | Nurse Practitioner | Liberty Hospital 2525 Glen Hendren Dr, Liberty, MO 64068 | 2017-07-21 |
| 1730566175 | John Mason Douglas | Nurse Practitioner | 102 W Freedom Dr, Liberty, MS 39645 | 2015-05-06 |
| 1700221413 | Sukhdeep Johal | Nurse Practitioner | 1901 W Kansas St # Mo001, Liberty, MO 64068-2060 | 2013-05-08 |
| 1215272166 | Ruth Teague | Nurse Practitioner | 2718 N Main St, Liberty, TX 77575-3909 | 2012-12-04 |
| 1376805499 | Caroline E Baugess | Nurse Practitioner | 504 N Greensboro St, Liberty, NC 27298-2601 | 2012-06-14 |
| 1326308636 | Tracy Mathews Allen | Nurse Practitioner | 1343 County Road 2005, Liberty, TX 77575-8709 | 2012-05-21 |
| 1770721003 | Cheryl Jean Wells | Nurse Practitioner | 129 S Fayetteville St, Liberty, NC 27298-3200 | 2009-01-23 |
| 1730373309 | M Therese Sellers | Nurse Practitioner | 109 N Blue Jay Dr, Liberty, MO 64068-1906 | 2007-08-28 |
| Find all providers in LIBERTY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.