Provider Demographics
NPI:1851743165
Name:BUCHANAN, TERRY (NP-C)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 NORTHPARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2695
Mailing Address - Country:US
Mailing Address - Phone:281-310-8445
Mailing Address - Fax:
Practice Address - Street 1:300 NORTHPARK DR STE 100
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2695
Practice Address - Country:US
Practice Address - Phone:281-310-8445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131311363LF0000X, 363LF0000X
OR201801792NP-PP363LF0000X
CA95008906363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty