Individual
MR. JAYSON J TERRES
Active
Individual
MR. JAYSON J TERRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD, FACS, FAACS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22097
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
M4965
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
M4965
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195649203
—
TX
01
—
22097
TEXAS STATE DENTAL LICENSE
TX
01
—
751572652
GROUP ID
—
01
—
M4965
TEXAS MEDICAL LICENSE
TX
Enumeration date
11/29/2006
Last updated
02/23/2023
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