SUSAN D ODOM PHD PC
Agencies at Wurzbach Rd, San Antonio, TX

License number
Texas 33728
Category
Agencies
Type
Community/Behavioral Health
Owner
Name: DR. SUSAN D ODOM PHD
Title: PSYCHOLOGIST
Phone: (210) 698-1100
Address
Address
11107 Wurzbach Rd SUITE 403, San Antonio, TX 78230
National Provider ID: 1235579178
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SUSAN D. ODOM PH.D., PC

San Antonio, TX

Doing business as:
Susan D. Odom PH.D., PC
Registration:
Jun 20, 2013
Addresses:
PO Box 782061, San Antonio, TX 78278 (Mailing)
11107 Wurzbach Rd, San Antonio, TX 78230
State ID:
0801804338
Business type:
Domestic Professional Corporation
DIRECTOR, Director, President:
Susan D Odom (DIRECTOR, Director, President), 11107 Wurzbach Pkwy SUITE 403, San Antonio, TX 78230
Agent:
Susan D. Odom,11107 Wurzbach Pkwy SUITE 403, San Antonio, TX 78230 (Physical)
TIN:
32051306648

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