Provider Demographics
NPI:1861539454
Name:ANDERSON, TERRENCE DAMON (MD)
Entity type:Individual
Prefix:
First Name:TERRENCE
Middle Name:DAMON
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15200 SOUTHWEST FWY STE 350
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3880
Mailing Address - Country:US
Mailing Address - Phone:713-714-1256
Mailing Address - Fax:727-781-3312
Practice Address - Street 1:15200 SOUTHWEST FWY STE 350
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3880
Practice Address - Country:US
Practice Address - Phone:713-714-1256
Practice Address - Fax:727-781-3312
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5965207X00000X, 207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ5965OtherTEXAS MEDICAL LICENSE