Provider Demographics
NPI:1568460848
Name:PICK, TERRY E (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:E
Last Name:PICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8407 BANDERA RD
Mailing Address - Street 2:#137
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-2574
Mailing Address - Country:US
Mailing Address - Phone:210-520-9997
Mailing Address - Fax:210-520-9972
Practice Address - Street 1:8407 BANDERA RD
Practice Address - Street 2:#137
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-2574
Practice Address - Country:US
Practice Address - Phone:210-520-9997
Practice Address - Fax:210-520-9972
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG1148208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139340722Medicaid
TX0073JUOtherBLUE CROSS AND B.S
TX45D1012386OtherLAB EXEMPTION
TX139340720Medicaid
TX611440421OtherPRIVATE INSURANCE
TX139340722Medicaid