Individual
DR. TODD AUSTIN TIBBETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
8401 DATAPOINT DR, SUITE 600, SAN ANTONIO, TX 78229-5900
(210) 616-7700
(210) 616-7709
Mailing address
8401 DATAPOINT DR, SUITE 600, SAN ANTONIO, TX 78229-5900
(210) 616-7700
(210) 616-7709
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L5925
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1562076-06
—
TX
05
—
1562076-08
—
TX
05
—
1562076-09
—
TX
01
—
L5925
TEXAS MEDICAL LICENSE
TX
01
—
P00433521
RAILROAD MEDICARE
TX
01
—
P00449060
RAILROAD MEDICARE
TX
Enumeration date
11/18/2005
Last updated
04/07/2016
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