Provider Demographics
NPI:1134818305
Name:TUBBS, YVONNE (NP)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:TUBBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W 45TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3014
Mailing Address - Country:US
Mailing Address - Phone:512-320-1500
Mailing Address - Fax:512-459-1399
Practice Address - Street 1:408 W 45TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-3014
Practice Address - Country:US
Practice Address - Phone:512-320-1500
Practice Address - Fax:512-459-1399
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1165938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner