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General NPI Number Information
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NPI Number | 1699133595
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Entity Type | Individual
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Provider Name | TERRY HARDIN JR. CSFA
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Gender | Male
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 2437 BAY AREA BLVD
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City | HOUSTON
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State | TX
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Zip | 77058-1519
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Country | US
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Telephone | 832-330-1508
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Fax | 866-576-4221
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Provider Business Mailing Address
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Address Line | 2437 BAY AREA BLVD
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City | HOUSTON
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State | TX
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Zip | 77058-1519
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Country | US
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Telephone | 832-330-1508
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Fax | 866-576-4221
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | CSFA# 163767
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License Number State | TX
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