Provider Demographics
NPI:1003306812
Name:THREATT, TABITHA (MD)
Entity type:Individual
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First Name:TABITHA
Middle Name:
Last Name:THREATT
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7703 FLOYD CURL DRIVE
Mailing Address - Street 2:MAIL CODE 7742
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5544
Mailing Address - Country:US
Mailing Address - Phone:210-567-5711
Mailing Address - Fax:
Practice Address - Street 1:602 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3364
Practice Address - Country:US
Practice Address - Phone:806-743-2373
Practice Address - Fax:806-743-4354
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2024-07-23
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Provider Licenses
StateLicense IDTaxonomies
TXU90952086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care