Provider Demographics
NPI:1154332625
Name:SALES, TERRY LYNTON (PT)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LYNTON
Last Name:SALES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 EXCHANGE ST
Mailing Address - Street 2:SUITE K
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4588
Mailing Address - Country:US
Mailing Address - Phone:817-447-2888
Mailing Address - Fax:817-447-2330
Practice Address - Street 1:225 EXCHANGE ST
Practice Address - Street 2:SUITE K
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4588
Practice Address - Country:US
Practice Address - Phone:817-447-2888
Practice Address - Fax:817-447-2330
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1026599225100000X
OK2442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist