Provider Demographics
NPI:1417016882
Name:MCNEARNEY, TERRY ANN (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:ANN
Last Name:MCNEARNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:ANN
Other - Last Name:MCNEARNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-1022
Mailing Address - Country:US
Mailing Address - Phone:409-747-0890
Mailing Address - Fax:409-772-0885
Practice Address - Street 1:400 HARBORSIDE DR
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0001
Practice Address - Country:US
Practice Address - Phone:409-747-0890
Practice Address - Fax:409-772-0885
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3605207RR0500X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80T850Medicare ID - Type Unspecified
TXF86745Medicare UPIN