Provider Demographics
NPI:1922082106
Name:BOBO, TERESA J (DO)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:J
Last Name:BOBO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:134 ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-4622
Mailing Address - Country:US
Mailing Address - Phone:210-824-6986
Mailing Address - Fax:210-295-4215
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-539-9582
Practice Address - Fax:210-295-4215
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2021-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK0422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine