Exstrum, Terry Dale
Exstrum, Terry Dale is an individual health care provider with primary practice located at 4708 Alliance Blvd Ste 300 Baylor Medical Plaza 1, Plano TX 75093-5339. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is his primary health care specialty. Exstrum, Terry Dale can be contacted via phone (972) 758-6000.Contact Information
Primary practice address
4708 Alliance Blvd Ste 300 Baylor Medical Plaza 1
Plano TX 75093-5339
Phone: (972) 758-6000
Fax: (972) 758-6001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | K8140 | Texas |
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | K8140 | Texas |
Profile Details
| NPI number | 1871607424 |
|---|---|
| LBN Legal business name | Exstrum, Terry Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Dec 15th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871607424 | NPPES |
| Texas | MEDICAID | 043126401 | |
| Texas | MEDICAID | 0431264-02 | |
| Texas | Other | 87195S |
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