Dr. Rudolph A. Theobald
Rehabilitation Chiropractor
6431 Soutwest Blvd
Fort Worth
, Texas 76132-5606
Dr. Rudolph A. Theobald
Rehabilitation Chiropractor
6431 Soutwest Blvd
Fort Worth
, Texas 76132-5606
(817) 423-4441
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About
Features
Specialties
- Rehabilitation Chiropractor
Languages spoken
- English
Location
First Address
- Dr. Rudolph A. Theobald
- Po Box 123525
- Fort Worth, TX
- Zip : 76121-3525
- Fax : (817) 423-4441
- Phone : (817) 228-2896
Second Address
- Dr. Rudolph A. Theobald
- 6431 Soutwest Blvd
- Fort Worth, TX
- Zip : 76132-5606
- Fax : (817) 738-9779
- Phone : (817) 738-9777
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NR0400X | Rehabilitation Chiropractor | 8869 | TX |
National Provider Identifier
| NPI | 1386729929 |
|---|---|
| Provider Name | Dr. Rudolph A. Theobald |
| First Address | Fort Worth, TX 76121-3525 |
| Second Address | Fort Worth, TX 76132-5606 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/10/2006 |
| Last Update Date | 07/05/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 104065 | AMERIGROUP (01) | TX |
| 11384841 | CAQH (01) | TX |
| 149696001 | (05) | TX |
| 1997117 | FIRST HEALTH (01) | TX |
| 606350 | BCBS PAR PLAN (01) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.