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General NPI Number Information
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NPI Number | 1063214195
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Entity Type | Individual
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Provider Name | AERMON J THEODORE-LEE DC
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Gender | Male
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 13925 NORTHWEST BLVD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78410-5118
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Country | US
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Telephone | 361-767-3300
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Fax | 361-767-3320
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Provider Business Mailing Address
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Address Line | 13925 NORTHWEST BLVD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78410-5118
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Country | US
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Telephone | 361-767-3300
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Fax | 361-767-3320
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 16179
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License Number State | TX
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