Active NPI
Gwen Terry, P.T.
- Physical Therapist
- Waco, TX
National Provider Identifier
1174636138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1089621
- Practice address
- 4800 Memorial Dr
Waco, TX 76711-1329 - Phone
- (254) 297-3525
- Fax
- (254) 297-3875
- NPI assigned
- Aug 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1089621 | TX | Primary |
Addresses
Primary practice location
4800 Memorial Dr
Waco, TX 76711-1329
Mailing address
4208 McKenzie Ave
Waco, TX 76710-2138
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1089621 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174636138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4208 MCKENZIE AVE",
"city": "WACO",
"state": "TX",
"postal_code": "767102138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 MEMORIAL DR",
"city": "WACO",
"state": "TX",
"postal_code": "767111329",
"telephone_number": "254-297-3525",
"fax_number": "254-297-3875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "GWEN",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1089621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
- Temple Vamc
- Temple Vamc
- Teresa Rejuvenating Psychiatry PLLC
- Rebecca Terrill, RBT-24-378964
- Allison Nicole Terry, SLP-ASSISTANT
- Texan Nursing and Rehab of Waco LLC (Care Inn of Waco, LLC)
- Texas Aalaga Ventures, LLC (Comfort Keepers of Waco)
- Texas Cardiac Arrythmia PLLC
- Texas Cardiovascular Consultants, PA
- Texas Cardiovascular Consultants, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.