Provider Demographics
NPI:1306191986
Name:TERRY, ANTHONY CHRISTIAN (CSFA)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:CHRISTIAN
Last Name:TERRY
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 FM 1103 UNIT 386
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2620
Mailing Address - Country:US
Mailing Address - Phone:210-279-8634
Mailing Address - Fax:
Practice Address - Street 1:725 FM 1103 UNIT 386
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-2620
Practice Address - Country:US
Practice Address - Phone:210-279-8634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant