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Organization
TERRY D. NEWSOM, M.D., P.A.
Active
Organization
TERRY D. NEWSOM, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY D. NEWSOM M.D. (PRESIDENT)
(972) 519-1100
Entity
Organization
Contact information
Practice address
4005 W 15TH ST, PLANO, TX 75093-5818
(972) 519-1100
Mailing address
2701 W 15TH ST # 550, PLANO, TX 75075-7523
(214) 842-4983
(214) 842-4983
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D8366
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000M735
BLUE SHIELD OF TEXAS
TX
Enumeration date
11/07/2010
Last updated
11/12/2015
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