| Theory Health Medical Clinic | |
|
135 Oyster Creek Dr Ste E Lake Jackson TX 77566-4119 | |
| (830) 513-7215 | |
| Not Available |
| Full Name | Theory Health Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 135 Oyster Creek Dr Ste E, Lake Jackson, Texas |
| Authorized Official Name and Position | Stephanie Alisa Zamora (ADMINISTRATOR/CLINICIAN) |
| Authorized Official Contact | 9792973387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theory Health Medical Clinic 135 Oyster Creek Dr Ste E Lake Jackson TX 77566-4119 Ph: (979) 297-3387 | Theory Health Medical Clinic 135 Oyster Creek Dr Ste E Lake Jackson TX 77566-4119 Ph: (830) 513-7215 |
| NPI Number | 1700434859 |
|---|---|
| Provider Enumeration Date | 09/02/2019 |
| Last Update Date | 09/02/2020 |
| Medicare PECOS PAC ID | 4587996269 |
|---|---|
| Medicare Enrollment ID | O20191030000543 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700434859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Jeevan C Gowda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881862027 PECOS PAC ID: 2264590082 Enrollment ID: I20090910000531 |
| Provider Name | Stephanie A Zamora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083845218 PECOS PAC ID: 3173708633 Enrollment ID: I20110426000827 |
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