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General NPI Number Information
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NPI Number | 1770596041
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Entity Type | Individual
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Provider Name | GINA RENEA STUBBS DO
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 9417 MESA DR STE A
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City | HOUSTON
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State | TX
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Zip | 77028-1253
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Country | US
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Telephone | 713-848-7780
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Fax | 833-710-0641
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Provider Business Mailing Address
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Address Line | PO BOX 746079
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City | ATLANTA
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State | GA
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Zip | 30374-6079
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 220369
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M3756
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License Number State | TX
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