Provider Demographics
NPI:1013602713
Name:WEBB, THERESA ALLISON
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ALLISON
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:A
Other - Last Name:JANKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:177 LAKEVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LA VERNIA
Mailing Address - State:TX
Mailing Address - Zip Code:78121-5101
Mailing Address - Country:US
Mailing Address - Phone:210-848-8404
Mailing Address - Fax:
Practice Address - Street 1:5700 SCHERTZ PKWY
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1495
Practice Address - Country:US
Practice Address - Phone:210-625-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician