Healthcare Provider Details

I. General information

NPI: 1871639724
Provider Name (Legal Business Name): TERRI KATHLEEN CRIMMINS-TUBB M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 MERTON MINTER ST
SAN ANTONIO TX
78229-4404
US

IV. Provider business mailing address

7400 MERTON MINTER ST
SAN ANTONIO TX
78229-4404
US

V. Phone/Fax

Practice location:
  • Phone: 210-706-7800
  • Fax:
Mailing address:
  • Phone: 210-706-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberN0713
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: