Provider Demographics
NPI:1952389686
Name:WU, THEODORE LIN HAI (MD)
Entity type:Individual
Prefix:
First Name:THEODORE
Middle Name:LIN HAI
Last Name:WU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC 7829
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-562-5800
Mailing Address - Fax:210-562-5200
Practice Address - Street 1:7703 FLOYD CURL DR
Practice Address - Street 2:MC 7829
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-562-5810
Practice Address - Fax:210-562-5200
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN48532080P0203X
NV11509208000000X
CAA907662080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506792Medicaid
TX205226801Medicaid
NVCS13513OtherSTATE PHARMACY
NV100506655Medicaid
NV100506655Medicaid
NVBW9328469OtherDEA
NV101469Medicare ID - Type UnspecifiedMEDICARE