Provider Demographics
NPI:1952539587
Name:SPEER, TERRY WAYNE (ANP)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:WAYNE
Last Name:SPEER
Suffix:
Gender:M
Credentials:ANP
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 17685
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7685
Mailing Address - Country:US
Mailing Address - Phone:713-777-5334
Mailing Address - Fax:281-565-1102
Practice Address - Street 1:1111 HIGHWAY 6 STE 194
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4900
Practice Address - Country:US
Practice Address - Phone:713-777-5334
Practice Address - Fax:281-565-1102
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX667655363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner