Provider Demographics
NPI:1659550689
Name:TERRY R SUMMERS DDS
Entity Type:Organization
Organization Name:TERRY R SUMMERS DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:361-851-1876
Mailing Address - Street 1:5920 SARATOGA BLVD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4119
Mailing Address - Country:US
Mailing Address - Phone:361-851-1876
Mailing Address - Fax:361-890-0980
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4119
Practice Address - Country:US
Practice Address - Phone:361-851-1876
Practice Address - Fax:361-890-0980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168761223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty