Individual
MICHAEL JEROME TUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
2126 BEACON LIGHT LN, FRESNO, TX 77545
(832) 428-1862
Mailing address
2126 BEACON LIGHT LN, FRESNO, TX 77545-7089
(832) 281-8624
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
4081
TX
246ZS0410X
Surgical Technologist
4081
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4081
CERTIFIED SURGICAL ASSISTANTS
TX
Enumeration date
06/14/2014
Last updated
06/11/2018
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