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Individual

DR. TERRY DALE EXSTRUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4708 ALLIANCE BLVD STE 300, BAYLOR MEDICAL PLAZA 1, PLANO, TX 75093-5339
(972) 758-6000
(972) 758-6001
Mailing address
4708 ALLIANCE BLVD STE 300, BAYLOR MEDICAL PLAZA 1, PLANO, TX 75093-5339
(972) 758-6000
(972) 758-6001

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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