Healthcare Provider Details

I. General information

NPI: 1326028986
Provider Name (Legal Business Name): TERRANCE A MCBURNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 10/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 DATAPOINT DR
SAN ANTONIO TX
78229-2028
US

IV. Provider business mailing address

9600 DATAPOINT DR
SAN ANTONIO TX
78229-2028
US

V. Phone/Fax

Practice location:
  • Phone: 210-892-3715
  • Fax: 210-617-4692
Mailing address:
  • Phone: 210-892-3715
  • Fax: 210-617-4692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberE8067
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: