Individual
CHARLES PATRICK THEIVAGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 VICTORIA LN STE 5, HARLINGEN, TX 78550-3231
(956) 362-8920
(956) 362-8935
Mailing address
PO BOX 749, PHARR, TX 78577-1614
(956) 362-8920
(956) 362-8935
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M3764
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396840682
—
TX
Enumeration date
09/13/2006
Last updated
03/17/2026
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