Lacey Shannon Odell, PT, DPT
Physical Therapist in Austin, TX. Individual provider (NPI-1).
NPI number1649934019
StatusActive
Last updated in NPPESOct 22, 2021
Details
- NPI
- 1649934019
- Entity type
- Individual (NPI-1)
- Name
- Lacey Shannon Odell
- Credential
- PT, DPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 22, 2021
- Certification date
- Oct 22, 2021
- Last updated
- Oct 22, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 1353750 | TX | Yes |
Practice location
711 W 38th St Ste B3&B4Austin, TX 78705-1121
Phone 512-450-0909
Mailing address
6712 Crosne StAustin, TX 78754-4411
Phone 915-443-0470
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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