Provider Demographics
NPI:1093874117
Name:STEGMAN, TERENCE RICHARD (PT)
Entity Type:Individual
Prefix:MR
First Name:TERENCE
Middle Name:RICHARD
Last Name:STEGMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:RICHARD
Other - Last Name:STEGMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:5445 PRESTON OAKS RD
Mailing Address - Street 2:APT 423
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-2418
Mailing Address - Country:US
Mailing Address - Phone:214-485-4522
Mailing Address - Fax:
Practice Address - Street 1:5445 PRESTON OAKS RD
Practice Address - Street 2:APT 423
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-2418
Practice Address - Country:US
Practice Address - Phone:214-485-4522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1107415225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist