Healthcare Provider Details

I. General information

NPI: 1174589758
Provider Name (Legal Business Name): TERRY CREEL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 HOUMA BLVD EMERGENCY DEPARTMENT
METAIRIE LA
70006-2970
US

IV. Provider business mailing address

4200 HOUMA BLVD
METAIRIE LA
70006-2970
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-0180
  • Fax: 210-566-5698
Mailing address:
  • Phone: 45-503-5684
  • Fax: 504-503-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number018184
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: