Provider Demographics
NPI:1114925724
Name:KING, TERESA ELISABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ELISABETH
Last Name:KING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:ELISABETH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2660 SCRIPTURE ST STE 110
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4340
Mailing Address - Country:US
Mailing Address - Phone:940-591-7900
Mailing Address - Fax:
Practice Address - Street 1:2660 SCRIPTURE ST STE 110
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4340
Practice Address - Country:US
Practice Address - Phone:940-591-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8770207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K8177Medicare PIN
TXG98338Medicare UPIN
TX403901YKP5Medicare PIN