Provider Demographics
NPI:1679587182
Name:TIMMONS, TERESA A (MD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:A
Last Name:TIMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 N JOHN REDDITT DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-1776
Mailing Address - Country:US
Mailing Address - Phone:936-671-4351
Mailing Address - Fax:936-671-4321
Practice Address - Street 1:2206 N JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-1776
Practice Address - Country:US
Practice Address - Phone:936-671-4351
Practice Address - Fax:936-671-4321
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ217482084P0800X
MN294212084P0800X
ND57502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry