THEODORE INTHAPHOM

HOUSTON, TX
NPI1689202475
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: TX  PA13459)
Enumeration Date2020-03-29
Last Update Date2022-08-04
Business Address
THEODORE INTHAPHOM
6400 FANNIN ST STE 1700
HOUSTON, TX 77030-1526
Phone number: 682-554-4173
Mailing Address
THEODORE INTHAPHOM
6400 FANNIN ST STE 1700
HOUSTON, TX 77030-1526
Phone number: 682-554-4173
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