Organization
THEOBALD MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA THEOBALD (OWNER)
(940) 230-3173
Entity
Organization
Contact information
Practice address
13058 E HIGHWAY 175 STE 4, KEMP, TX 75143-4596
(940) 230-3173
Mailing address
13058 E HIGHWAY 175 STE 4, KEMP, TX 75143-4596
(940) 230-3173
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/03/2026
Last updated
03/03/2026
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