Provider Demographics
NPI:1356346134
Name:LABBE', THERESA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:MARIE
Last Name:LABBE'
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:THERESA
Other - Middle Name:MARIE
Other - Last Name:DECAPRIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3510 ROSEDOWN DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-9215
Mailing Address - Country:US
Mailing Address - Phone:361-947-4743
Mailing Address - Fax:
Practice Address - Street 1:3510 ROSEDOWN DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-9215
Practice Address - Country:US
Practice Address - Phone:361-947-4743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1999207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0086LPOtherBLUE CROSS/BLUE SHIELD
AR150015001Medicaid
TX0463432-04Medicaid
AR82493OtherBLUE CROSS/BLUE SHIELD
TX0463432-04Medicaid
AR82493OtherBLUE CROSS/BLUE SHIELD