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General NPI Number Information
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NPI Number | 1053365213
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Entity Type | Individual
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Provider Name | TERRY L BAGLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 13451 N 94TH DR
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City | PEORIA
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State | AZ
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Zip | 85381-5056
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Country | US
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Telephone | 623-303-7101
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 WOODSTEAD CT STE 208
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1480
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Country | US
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Telephone | 281-724-3100
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Fax | 281-724-3100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 31433
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License Number State | AZ
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