Provider Demographics
NPI:1902523525
Name:ODIMA, ANNE A (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:ANNE
Middle Name:A
Last Name:ODIMA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 ORCHARD CLUB DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3265
Mailing Address - Country:US
Mailing Address - Phone:832-868-3398
Mailing Address - Fax:
Practice Address - Street 1:3911 ORCHARD CLUB DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3265
Practice Address - Country:US
Practice Address - Phone:832-868-3398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist