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NPI Code Detail

MEDICARE: TEODULO J AVES, MD PA

MEDICARE: TEODULO J AVES, MD PA
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
1207LP2900XPain Medicine (Anesthesiology) Physician
2111NR0400XRehabilitation Chiropractor

General Provider Information

NPI Number : 1871114967
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEODULO J AVES, MD PA
Provider Business Mailing Address
First Line : PO BOX 218486
Second Line :
City : HOUSTON
State : TX
Zip : 77218-8486
Country : US
Telephone Number : 713-545-9191
Fax Number :
Provider Business Practice Location Address
First Line : 4615 SOUTHWEST FWY STE 850
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7162
Country : US
Telephone Number : 832-767-2280
Fax Number :
Authorized Official
Title or Position : BOOKKEEPER/MANAGER
Name : BROWNIE SHOTT
Credential :
Telephone Number : 713-545-9191
Provider Enumeration Date : 04/30/2020
Last Update Date : 04/30/2020

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Directions to “TEODULO J AVES, MD PA ” Practice Location

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