Provider Demographics
NPI:1235212010
Name:CHEELEY, TERRI L (PA-C)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:CHEELEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1276 SOUTH PEACHTREE STREET
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-3345
Mailing Address - Country:US
Mailing Address - Phone:409-384-5701
Mailing Address - Fax:409-384-4238
Practice Address - Street 1:2200 HIGHWAY 83 WEST
Practice Address - Street 2:
Practice Address - City:HEMPHILL
Practice Address - State:TX
Practice Address - Zip Code:75948
Practice Address - Country:US
Practice Address - Phone:409-787-3772
Practice Address - Fax:409-787-4506
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA02453363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical