Individual
TERRA WUBBENHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2211 LOMAS BLVD NE, MSC 10-6000, ALBUQUERQUE, NM 87106-2719
(505) 272-2610
(505) 272-1300
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD2018-0687
NM
207L00000X
Anesthesiology Physician
P9036
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332344603
—
TX
05
—
332344604
—
TX
01
—
8FN269
BCBS
TX
Enumeration date
08/10/2009
Last updated
10/30/2024
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