Provider Demographics
NPI:1821078387
Name:JONES, TERRY M (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1707 BROADMOOR DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-5233
Mailing Address - Country:US
Mailing Address - Phone:979-776-7767
Mailing Address - Fax:979-774-4986
Practice Address - Street 1:1707 BROADMOOR DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-5233
Practice Address - Country:US
Practice Address - Phone:979-776-7767
Practice Address - Fax:979-774-4986
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE2645207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE2645OtherLICENSE