Dr Teresa Lorraine Loden, DO | |
1337 S Sam Houston Blvd, Houston, MO 65483-2046 | |
(417) 967-5435 | |
(417) 967-5503 |
Full Name | Dr Teresa Lorraine Loden |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 1337 S Sam Houston Blvd, Houston, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730527318 | NPI | - | NPPES |
26D0889777 | Other | MO | CLIA |
200053618 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 1476 (Nebraska) | Secondary |
208000000X | Pediatrics | 2018008048 (Missouri) | Primary |
Entity Name | Texas County Memorial Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306885587 PECOS PAC ID: 9436041696 Enrollment ID: O20040325000339 |
Mailing Address | Practice Location Address |
---|---|
Dr Teresa Lorraine Loden, DO 1337 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-5435 | Dr Teresa Lorraine Loden, DO 1337 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-5435 |
Mr. Jamal A Zereik, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1333 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-3311 Fax: 417-967-1259 | |
Mrs. Patricia A Benoist, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1337 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-5639 Fax: 417-967-5667 |