Provider Demographics
NPI:1407930399
Name:MCLENDON, TERRY BOWMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:BOWMAN
Last Name:MCLENDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:STE 1001
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-0005
Mailing Address - Fax:713-790-3026
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:MAIN BUILDING, SUITE 592
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-0005
Practice Address - Fax:713-790-3026
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004-01540207R00000X
TXN8952208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H81942Medicare ID - Type Unspecified
NC2047421Medicare ID - Type Unspecified
NC5902298Medicare ID - Type Unspecified