# THEOBALD MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700731957
- **Authorized official:** ANGELA THEOBALD (OWNER)
- **Authorized official phone:** (940) 230-3173

## Contact information

- **Practice address:** 13058 E HIGHWAY 175 STE 4, KEMP, TX 75143-4596
- **Practice address phone:** (940) 230-3173
- **Mailing address:** 13058 E HIGHWAY 175 STE 4, KEMP, TX 75143-4596
- **Mailing address phone:** (940) 230-3173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/03/2026
- **Last updated:** 03/03/2026