Provider Demographics
NPI:1134896194
Name:TUBBS, COLLIN (OD)
Entity type:Individual
Prefix:DR
First Name:COLLIN
Middle Name:
Last Name:TUBBS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 S IH 35 UNIT 2304
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2659
Mailing Address - Country:US
Mailing Address - Phone:512-419-8776
Mailing Address - Fax:
Practice Address - Street 1:9600 S IH 35 STE S225
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-3889
Practice Address - Country:US
Practice Address - Phone:512-291-0876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10250T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist