Blake Orion Theabold, DO is a
Student In An Organized Health Care Education/training Program physician based in Corpus Christi, Texas. Blake Orion Theabold is licensed to practice in * (Not Available) (license number ) and his current practice location is 600 Elizabeth St # 9b9.209, Corpus Christi, Texas. He can be reached at his office (for appointments etc.) via phone at
(361) 861-1864.
NPI number for Blake Orion Theabold is 1568216596 and his current mailing address is 600 Elizabeth St # 9b9.209, Corpus Christi, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568216596.
Physician's Profile
| Full Name | Blake Orion Theabold |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 600 Elizabeth St # 9b9.209, Corpus Christi, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1568216596
- Provider Enumeration Date: 04/16/2024
- Last Update Date: 05/08/2026
Medical Identifiers
Medical identifiers for Blake Orion Theabold such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568216596 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | W5584 (Texas) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Orion Theabold is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Blake Orion Theabold, DO
600 Elizabeth St # 9b9.209,
Corpus Christi, TX 78404-2235
Ph: () - | Blake Orion Theabold, DO
600 Elizabeth St # 9b9.209,
Corpus Christi, TX 78404-2235
Ph: (361) 861-1864 |
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