Individual provider · Type 1 NPI
Jennifer Anne Theoharis, MD
Diagnostic Radiology Physician · Boerne, TX
NPI number
1659356913
Active
Practice location
9002 Highlands Cv
Boerne, TX 78006-4843
Fax (612) 294-4903
Mailing address
11995 Singletree Ln Ste 500
Eden Prairie, MN 55344-5349
Other practice locations
- 7211 Wellington Dr Ste 101, Knoxville, TN 37919-5968 · (865) 588-8005
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diagnostic Radiology Physician Primary | 2085R0202X | M0943 (TX) |
| Diagnostic Radiology Physician | 2085R0202X | A85035 (CA) |
| Diagnostic Radiology Physician | 2085R0202X | 045784 (CT) |
| Diagnostic Radiology Physician | 2085R0202X | 37923 (TN) |
Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Other diagnostic radiology physician providers in Boerne
About NPI 1659356913
Jennifer Anne Theoharis, MD's National Provider Identifier is 1659356913, issued on Dec 9, 2005. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Boerne, TX. The record was last updated on Jan 20, 2026.