Organization Name: | TERRY A. CLYBURN, M. D., P.A. |
NPI Number: | 1083789002 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERRY ALAN CLYBURN (OWNER) |
Mailing Address: | 5420 West Loop S Suite 2400 Bellaire |
State: | TX US |
Postal Code: | 774012107 |
Phone Number: | 7133574752 |
Fax Number: | 8322130308 |
NPI Enumeration Date: | 11/22/2006 |
NPI Last Update Date: | 11/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | F3846 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |