Clark Don Terrell, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G8987 Issued in TX

Practice address

11124 Wurzbach Rd
Ste 206
San Antonio, TX 78230-2445

Phone

(210) 696-0076

Fax

(210) 697-7207

NPI assigned

Jul 15, 2005

Last updated

Jul 12, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2014 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1700885415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11124 WURZBACH RD",
            "address_2": "SUITE 206",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302438",
            "telephone_number": "210-696-0076",
            "fax_number": "210-697-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11124 WURZBACH RD",
            "address_2": "STE 206",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302445",
            "telephone_number": "210-696-0076",
            "fax_number": "210-697-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "CLARK",
        "middle_name": "DON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "G8987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guillermo A. Terrazas, PT
• Maria Terrazas, SLP-ASSISTANT
• Thao Hoang Terrazas, RN
• Terrell Hills Dental
• Callie Ann Terrell, AUD
• Jonathan Terrell
• Kenneth Terrell, MD
• Esther Terrones, LMSW
• Terry L. Westfield, M.D., P.a.
• Bangorn Terry

• Psychiatry Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.