Provider Demographics
NPI:1821434630
Name:TUBRE, RYAN WEBSTER (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:WEBSTER
Last Name:TUBRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4293 KINSEY DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-1004
Mailing Address - Country:US
Mailing Address - Phone:903-690-7775
Mailing Address - Fax:903-690-7825
Practice Address - Street 1:4293 KINSEY DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1004
Practice Address - Country:US
Practice Address - Phone:903-690-7775
Practice Address - Fax:903-690-7825
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6697208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology