Individual
MARK ALLAN TEBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
310 CORIANDER BND, SAN ANTONIO, TX 78253-5471
(210) 771-1234
Mailing address
310 CORIANDER BND, SAN ANTONIO, TX 78253-5471
(210) 771-1234
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
153404
TX
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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