MEDICARE: DR. THERESA MARIE LABBE' MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	K1999	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0086LP	OTHER	TX	BLUE CROSS/BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	82493	OTHER	AR	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1356346134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THERESA MARIE LABBE' MD

Provider Business Mailing Address
First Line	:	3510 ROSEDOWN DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78418-9215
Country	:	US
Telephone Number	:	361-947-4743
Fax Number	:

Provider Business Practice Location Address
First Line	:	3510 ROSEDOWN DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78418-9215
Country	:	US
Telephone Number	:	361-947-4743
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	07/16/2013

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