Gus Theodos, M.D.

Interventional Cardiology Physician · Saint Louis, MO

Individual Active NPI

NPI number 1053401422

Practice location

3023 N Ballas Rd Ste 200d
Saint Louis, MO 63131-2328
Phone
(314) 996-7272

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NPI record

NPI
1053401422
Entity type
Individual (Type 1)
Enumeration date
October 13, 2006
Last updated
March 22, 2021
Certified
March 22, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Interventional Cardiology Physician Primary 207RI0011X 2016007344 MO

Mailing address

670 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8573

About Dr. Theodos

Gus Theodos, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Interventional Cardiology Physician (code 207RI0011X). The practice location is 3023 N Ballas Rd Ste 200d, Saint Louis, MO 63131-2328. The NPI number 1053401422 was assigned on October 13, 2006 and the record was last updated on March 22, 2021.

Dr. Theodos lists a license in the registry: #2016007344 (MO) for Interventional Cardiology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gus Theodos, M.D.?

The NPI number is 1053401422.

What is the phone number of Dr. Theodos?

The phone number listed for the practice location is (314) 996-7272.

Where is Dr. Theodos located?

3023 N Ballas Rd Ste 200d, Saint Louis, MO 63131-2328.

What is the taxonomy code for Dr. Theodos?

The primary taxonomy code is 207RI0011X – Interventional Cardiology Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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