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Individual

TERRY A CLYBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.,P.A.

Contact information

Practice address
6445 MAIN ST, SUITE 2500, HOUSTON, TX 77030-1502
(713) 441-9000
(713) 790-2058
Mailing address
6445 MAIN ST, SUITE 2500, HOUSTON, TX 77030-1502
(713) 441-9000
(713) 790-2058

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
F3846
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137857202
CSHCN
TX
05
137857211
TX
05
137857219
TX
01
200031823
RAILROAD MEDICARE
TX
01
81Z182
BCBS
TX
01
8FX450
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/11/2006
Last updated
08/30/2016
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