Provider Demographics
NPI:1275398166
Name:HUBERT, TEARINI SHONTAL
Entity Type:Individual
Prefix:
First Name:TEARINI
Middle Name:SHONTAL
Last Name:HUBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 COLE AVENUE
Mailing Address - Street 2:APT 102
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-3944
Mailing Address - Country:US
Mailing Address - Phone:979-398-9715
Mailing Address - Fax:
Practice Address - Street 1:915 COLE AVENUE
Practice Address - Street 2:APT 102
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-3944
Practice Address - Country:US
Practice Address - Phone:979-398-9715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator