Individual
THEODROS M ZEMANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11807 SOUTH FWY STE 363, BURLESON, TX 76028-7045
(817) 806-1143
(817) 806-1144
Mailing address
11807 SOUTH FWY STE 363, BURLESON, TX 76028-7045
(817) 806-1143
(817) 806-1144
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
T5709
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700379740
—
TX
01
—
8SM603
BCBS
—
Enumeration date
06/13/2018
Last updated
05/30/2023
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