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Individual

DR. TERRY R JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2215 E VILLA MARIA RD, #110, BRYAN, TX 77802-2548
(979) 776-2000
(979) 776-0427
Mailing address
2215 E VILLA MARIA RD, #110, BRYAN, TX 77802-2548
(979) 776-2000
(979) 776-0427

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
F8523
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102870601
TX
01
116001100
FIRST CARE PROVIDER ID
TX
01
830003621
MEDICARE RAILROAD
TX
Enumeration date
05/24/2006
Last updated
02/08/2010
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