Provider Demographics
NPI:1376658609
Name:SADLER, TERRY LYNN (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:LYNN
Last Name:SADLER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 JOE RAMSEY BLVD E STE 100
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7856
Mailing Address - Country:US
Mailing Address - Phone:903-408-5834
Mailing Address - Fax:903-408-7704
Practice Address - Street 1:4211 JOE RAMSEY BLVD E STE 100
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401
Practice Address - Country:US
Practice Address - Phone:903-408-7760
Practice Address - Fax:903-408-7762
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1141463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171843903Medicaid
TX663003OtherMEDICARE
TX8T4038OtherBC/BS