Provider Demographics
NPI:1386613313
Name:BURTON, TERI G (PT)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:G
Last Name:BURTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 EDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-6948
Mailing Address - Country:US
Mailing Address - Phone:325-665-8730
Mailing Address - Fax:
Practice Address - Street 1:2609 EDGEMONT DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6948
Practice Address - Country:US
Practice Address - Phone:325-665-8730
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1092443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist