Provider Demographics
NPI:1255077129
Name:TUBIO, TERRENCE ALEXANDER (DC)
Entity type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:ALEXANDER
Last Name:TUBIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:TERRENCE
Other - Middle Name:ALEXANDER
Other - Last Name:TUBIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:210 CENTURY SQUARE BLVD # 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3796
Mailing Address - Country:US
Mailing Address - Phone:832-589-5007
Mailing Address - Fax:281-261-7220
Practice Address - Street 1:210 CENTURY SQUARE BLVD # 200
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3796
Practice Address - Country:US
Practice Address - Phone:832-589-5007
Practice Address - Fax:281-261-7220
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor