Provider Demographics
NPI:1720204746
Name:TIMOTHY P. THURBER MD PA
Entity Type:Organization
Organization Name:TIMOTHY P. THURBER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR PHYSICIANS
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:THURBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-982-1561
Mailing Address - Street 1:18 PASEO PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526
Mailing Address - Country:US
Mailing Address - Phone:956-982-1561
Mailing Address - Fax:956-982-0498
Practice Address - Street 1:18 PASEO PLZ
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-1102
Practice Address - Country:US
Practice Address - Phone:956-982-1561
Practice Address - Fax:956-982-0498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8864174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092296502Medicaid
TX092296502Medicaid
TXE31003Medicare UPIN