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Individual
THUBA T TO
Active
Individual
THUBA T TO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
706236
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP118387
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206389304
—
TX
01
—
206389305
MEDICAID-CSHCN
TX
Enumeration date
05/27/2009
Last updated
11/04/2020
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