Provider Demographics
NPI:1700972874
Name:TERRY, GUY L (PT)
Entity Type:Individual
Prefix:MR
First Name:GUY
Middle Name:L
Last Name:TERRY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117213
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-7213
Mailing Address - Country:US
Mailing Address - Phone:972-939-6501
Mailing Address - Fax:866-451-0585
Practice Address - Street 1:3730 N JOSEY LN
Practice Address - Street 2:#124
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2484
Practice Address - Country:US
Practice Address - Phone:972-939-6501
Practice Address - Fax:866-451-0585
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10035118OtherAMERIGROUP INDIVIDUAL
TX8T3290OtherBCBS PROVIDER
TX173756101Medicaid
TX10035116OtherAMERIGROUP FACILITY
TX174753701Medicaid
TX8T3290OtherBCBS PROVIDER