Provider Demographics
NPI:1538482534
Name:WALKER, TERRIS JERMAINE
Entity Type:Individual
Prefix:MR
First Name:TERRIS
Middle Name:JERMAINE
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 MLK JR BLVD SUITE 202
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215
Mailing Address - Country:US
Mailing Address - Phone:817-726-9233
Mailing Address - Fax:
Practice Address - Street 1:2606 MLK JR BLVD STE 202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-6330
Practice Address - Country:US
Practice Address - Phone:817-726-9233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor