Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 13146 | TX |
NPI | 1023233525 |
---|---|
Provider Name | Dr. Terry Thames |
First Address | Carrollton, TX 75007-1525 |
Second Address | Carrollton, TX 75007-1525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |