Provider Demographics
NPI:1932298957
Name:TEOH, DOREEN L (MD)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:L
Last Name:TEOH
Suffix:
Gender:F
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:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-3199
Practice Address - Fax:682-885-7499
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4587207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137283113OtherCSHCN GRP MEDICAID TPI
1669442042OtherGRP NPI NUMBER
TX7999087OtherAETNA PIN
TX00L42VOtherBCBSTX GRP PIN
TX137283112OtherMEDICAID GROUP TPI
TX8H8787OtherBCBSTX IND PIN
TX100640504Medicaid
TX9084465OtherPHCS PIN
TX10064504Medicaid
TX10037197OtherAMERIGROUP PIN
TX100640505OtherCSHCN IND. MEDICAID TPI
TX1993478OtherUHC PIN
TX7999087OtherAETNA PIN
TX10037197OtherAMERIGROUP PIN
H22457Medicare UPIN