THEODORE INTHAPHOM
Physician Assistant (Medical)

Address: 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065

THEODORE INTHAPHOM (NPI# 1689202475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689202475
Entity Type Individual
Full Name THEODORE INTHAPHOM
Gender Male
Practice Address 25222 Northwest Fwy Apt 349
Cypress
TX 77429-1065
Practice Telephone 6825544173
Mailing Address 25222 Northwest Fwy Apt 349
Cypress
TX 77429-1065
Mailing Telephone 6825544173
Certification Date 2020-03-29
Enumeration Date 2020-03-29
Last Update Date 2020-03-29
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 363AM0700X Physician Assistant
Specialization: Medical
PA13459 TX Physician Assistants & Advanced Practice Nursing Providers

Physician Overview

PECOS Associate Control (PAC) ID 4082034905
by Medicare Provider Enrollment and Chain/Ownership System (PECOS)
Professional Enrollment ID I20201015000185
Last Name INTHAPHOM
First Name THEODORE
Middle Name E
Organization Legal Name UT PHYSICIANS
Location 6410 Fannin St, Houston, TX 77030-3005
Graduation Year 2019
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 8426960360
Number of Group Practice Members 1250

Office Location

Street Address 25222 NORTHWEST FWY APT 349
City CYPRESS
State TX
Zip Code 77429-1065

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1669957619 Nwh Rehab LLC Skilled Nursing Facility 13600 Birdcall Lane, Cypress, TX 77429 2018-09-26
1043798226 Creekside Family Practice Pllc Family Medicine 14502 Spring Cypress Rd Ste 500, Cypress, TX 77429 2018-07-31
1295295699 Ana Paula Mendez Nurse Practitioner - Primary Care 4216 Northwest Fwy, Suite 560, Cypress, TX 77429 2019-03-21
1093390296 Victoria Rose Angelle Dietitian, Registered Serenity Wellness & Counseling Center, 17774 Cypress Rosehill Road, Suite 400, Cypress, TX 77429 2021-03-10
1548762354 Cypress Cosmetic & Family Dentistry Dentist 24150 Highway 290 Ste 100, Cypress, TX 77429 2018-03-07
1710494307 Emcr Holdings, LLC · Eden Memory Care Assisted Living Facility 13058 Grant Road, Cypress, TX 77429 2018-01-04
1578065520 Jennifer Nguyen Physical Therapist 21208 Northwest Fwy, Cypress, TX 77429 2018-03-06
1144789546 Vanessa Frank · Vanessa Bennett Behavior Technician 12110 Huffmeister, Cypress, TX 77429 2019-03-15
1265903330 Cypress Rosehill Family Dentistry, Pllc Dentist - General Practice 15626 Cypress Rosehill Rd, Suite 300, Cypress, TX 77429 2018-12-16
1003304817 Amanda Kelso Behavior Technician 12110 Huffmeister Rd., Cypress, TX 77429 2018-04-26
Find all in zip 77429

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093317810 Delena Wu Physician Assistant - Medical 19030 Greenview Glen Dr, Cypress, TX 77433 2020-11-16
1043641764 Jennifer Nicole Dorchuck Physician Assistant - Medical 10720 Barker Cypress Rd, Cypress, TX 77433-1372 2013-12-05
1033196076 Tamara Ann Kapplinger Physician Assistant - Medical 21216 Northwest Freeway Ste 570, Cypress, TX 77429 2005-12-30
1649718883 Janine Rachael Zener Physician Assistant - Medical 21216 Northwest Fwy, Suite 550, Cypress, TX 77429-1439 2017-02-08
1912452152 Supreet Kaur Physician Assistant - Medical 21212 Northwest Fwy, Suite #: 205, Cypress, TX 77429-5884 2016-08-17
1639527252 Jean Barnett Physician Assistant - Medical 21212 Northwest Fwy, Suite 265, Cypress, TX 77429-5884 2016-05-25
1801291554 Sara Wingate Physician Assistant - Medical 10720 Barker Cypress Rd, Cypress, TX 77433-1372 2014-10-23
1639592140 Chelsie J Krobot Physician Assistant - Medical 25801 Hwy 290, Cypress, TX 77429-1049 2014-02-04
1720423841 Cypress Springs Family Care-Pearland, Pllc Physician Assistant - Medical 7630 Fry Rd, Suite 300, Cypress, TX 77433-3375 2013-05-02
1740520436 Maelyn Finkbine Physician Assistant - Medical 21216 Northwest Fwy Ste 620, Cypress, TX 77429-4699 2013-02-18
Find all providers in CYPRESS

Competitor

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City CYPRESS
Zip Code 77429

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1083729669 Theodore S Kytos Dentist - Endodontics 20 Fremont St, Suite 10a, Auxbury, MA 02332-5338 2006-08-21
1235714759 Theodore R Gover LLC Health Maintenance Organization 310 38th St, Vienna, WV 26105-1722 2021-03-16

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Dataset Information

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.