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NPI Code Detail

MEDICARE: DR. TERRY M JONES MD

MEDICARE:  DR. TERRY M JONES  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology PhysicianE2645TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E2645OTHERTXLICENSE

General Provider Information

NPI Number : 1821078387
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRY M JONES MD
Provider Business Mailing Address
First Line : 1707 BROADMOOR DR
Second Line : SUITE 100
City : BRYAN
State : TX
Zip : 77802-5233
Country : US
Telephone Number : 979-776-7767
Fax Number : 979-774-4986
Provider Business Practice Location Address
First Line : 1707 BROADMOOR DR
Second Line : SUITE 100
City : BRYAN
State : TX
Zip : 77802-5233
Country : US
Telephone Number : 979-776-7767
Fax Number : 979-774-4986
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 07/08/2007

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Directions to “ DR. TERRY M JONES MD” Practice Location

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