Individual
DR. JENNIFER ANNE THEOHARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9002 HIGHLANDS CV, BOERNE, TX 78006-4843
(952) 595-1100
(612) 294-4903
Mailing address
11995 SINGLETREE LN STE 500, EDEN PRAIRIE, MN 55344-5349
(952) 595-1301
(612) 294-4903
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
045784
CT
2085R0202X
Diagnostic Radiology Physician
37923
TN
2085R0202X
Diagnostic Radiology Physician
A85035
CA
2085R0202X
Diagnostic Radiology Physician
Primary
M0943
TX
Other
Enumeration date
12/09/2005
Last updated
01/20/2026
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