Provider Demographics
NPI:1568441723
Name:SAIEH, THEODORE A (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:A
Last Name:SAIEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 S STAPLES ST
Mailing Address - Street 2:SUITE # 404
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3150
Mailing Address - Country:US
Mailing Address - Phone:361-884-9575
Mailing Address - Fax:
Practice Address - Street 1:1521 S STAPLES ST
Practice Address - Street 2:SUITE # 404
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3150
Practice Address - Country:US
Practice Address - Phone:361-884-9575
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2470174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP082840N2Medicaid
TXZ008228K8Medicaid
TX8284ONMedicare ID - Type UnspecifiedTHEODORE A. SAIEH,MD
TXC-21473Medicare UPIN
TXP082840N2Medicaid