Provider Demographics
NPI:1437217361
Name:ROESER, THEODORE P (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:P
Last Name:ROESER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2095 W MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3576
Mailing Address - Country:US
Mailing Address - Phone:281-332-6699
Mailing Address - Fax:281-332-3993
Practice Address - Street 1:909 FROSTWOOD DR
Practice Address - Street 2:SUITE 1.100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2301
Practice Address - Country:US
Practice Address - Phone:713-338-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE8859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine