Exstrum, Terry Dale

Exstrum, Terry Dale is an individual health care provider with primary practice located at 4708 Alliance Blvd Ste 300 Baylor Medical Plaza 1, Plano TX 75093-5339. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is his primary health care specialty. Exstrum, Terry Dale can be contacted via phone (972) 758-6000.

Contact Information

Primary practice address
4708 Alliance Blvd Ste 300 Baylor Medical Plaza 1 Plano TX 75093-5339
Phone: (972) 758-6000
Fax: (972) 758-6001
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X K8140 Texas
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X K8140 Texas

Profile Details

NPI number 1871607424
LBN Legal business name Exstrum, Terry Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Dec 15th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871607424 NPPES
Texas MEDICAID 043126401
Texas MEDICAID 0431264-02
Texas Other 87195S

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