| Dr Teresa Lorraine Loden, DO | |
|
1337 S Sam Houston Blvd, Houston, MO 65483-2046 | |
| (417) 967-5435 | |
| (417) 967-5503 |
| Full Name | Dr Teresa Lorraine Loden |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1337 S Sam Houston Blvd, Houston, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730527318 | NPI | - | NPPES |
| 26D0889777 | Other | MO | CLIA |
| 200053618 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 1476 (Nebraska) | Secondary |
| 208000000X | Pediatrics | 2018008048 (Missouri) | Primary |
| Entity Name | Texas County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306885587 PECOS PAC ID: 9436041696 Enrollment ID: O20040325000339 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Teresa Lorraine Loden, DO 1337 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-5435 | Dr Teresa Lorraine Loden, DO 1337 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-5435 |
Mr. Jamal A Zereik, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1333 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-3311 Fax: 417-967-1259 | |
Mrs. Patricia A Benoist, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1337 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-5639 Fax: 417-967-5667 |