Individual provider · Type 1 NPI

Blake Orion Theabold, DO

Student in an Organized Health Care Education/Training Program · Corpus Christi, TX

NPI number 1568216596 Active

Practice location

600 Elizabeth St # 9B9.209
Corpus Christi, TX 78404-2235

Call (361) 861-1864 Map

Specialties and licenses

TaxonomyCodeLicense
Emergency Medicine Physician 207P00000XW5584 (TX)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1568216596

Blake Orion Theabold, DO's National Provider Identifier is 1568216596, issued on Apr 16, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Corpus Christi, TX. The record was last updated on May 8, 2026.