Healthcare Provider Details

I. General information

NPI: 1700768132
Provider Name (Legal Business Name): TERRY KARUOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1328 MAYWOOD CT
PLANO TX
75023-1914
US

IV. Provider business mailing address

14 AUDUBON RD APT 546
WAKEFIELD MA
01880-1342
US

V. Phone/Fax

Practice location:
  • Phone: 978-406-1083
  • Fax:
Mailing address:
  • Phone: 978-406-1083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number1019090
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number1019090
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1019090
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: