| Theta Care PLLC | |
|
2410 Luna Rd Ste 252 Carrollton TX 75006-6538 | |
| (972) 318-9731 | |
| (877) 360-0326 |
| Full Name | Theta Care PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2410 Luna Rd Ste 252, Carrollton, Texas |
| Authorized Official Name and Position | Michael Blackmon (MD) |
| Authorized Official Contact | 9723189731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theta Care PLLC 2410 Luna Rd Ste 248 Carrollton TX 75006-6578 Ph: (972) 318-9731 | Theta Care PLLC 2410 Luna Rd Ste 252 Carrollton TX 75006-6538 Ph: (972) 318-9731 |
| NPI Number | 1821835323 |
|---|---|
| Provider Enumeration Date | 07/11/2024 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821835323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| 251F00000X | Home Infusion | (NU) | Secondary |
| 251J00000X | Nursing Care | (NU) | Secondary |
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