Healthcare Provider Details

I. General information

NPI: 1619893542
Provider Name (Legal Business Name): PAMELA SNOW TUBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 AL HIGHWAY 14 E
SELMA AL
36703-3215
US

IV. Provider business mailing address

1501 AL HIGHWAY 14 E
SELMA AL
36703-3215
US

V. Phone/Fax

Practice location:
  • Phone: 334-874-8357
  • Fax: 334-874-7916
Mailing address:
  • Phone: 334-874-8357
  • Fax: 334-874-7916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number26509
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: