Individual
JORDAN MATTHEW TERASAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1208 BROOK AVE, WICHITA FALLS, TX 76301-5602
(940) 322-4480
(940) 322-8420
Mailing address
1208 BROOK AVE, WICHITA FALLS, TX 76301-5602
(940) 322-4480
(940) 322-8420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P2069
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
P2069
TX
207RP1001X
Pulmonary Disease Physician
Primary
P2069
TX
Other
Enumeration date
06/24/2009
Last updated
09/27/2019
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