Individual
DR. TERRY VINCENT PURSLEY
Active
Individual
DR. TERRY VINCENT PURSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
E6154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00817K
MEDICARE GROUP NUMBER
TX
01
—
070002444
MEDICARE B RR PALMETTO
TX
05
—
114166503
—
TX
01
—
45D0488829
CLIA NUMBER
TX
Enumeration date
09/26/2005
Last updated
10/23/2007
Update your record
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