Provider Demographics
NPI:1851524250
Name:TERRY, BEVERLY S (CMF)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:S
Last Name:TERRY
Suffix:
Gender:F
Credentials:CMF
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:S
Other - Last Name:ARIOLLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:521 GASLIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3127
Mailing Address - Country:US
Mailing Address - Phone:936-634-3298
Mailing Address - Fax:
Practice Address - Street 1:521 GASLIGHT BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3127
Practice Address - Country:US
Practice Address - Phone:936-634-3298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter