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Individual
DR. TERRY DALE EXSTRUM
Active
Individual
DR. TERRY DALE EXSTRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
K8140
TX
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
K8140
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0431264-02
—
TX
05
—
043126401
—
TX
01
—
87195S
BCBS
TX
Enumeration date
08/19/2006
Last updated
12/15/2008
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