Provider Demographics
NPI:1548263759
Name:GROVER, TERRY ALLEN (DO)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALLEN
Last Name:GROVER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2961 MOSSROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5119
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:105 FALLS COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2986
Practice Address - Country:US
Practice Address - Phone:830-249-3800
Practice Address - Fax:830-249-0882
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2015-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL5750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L2804OtherMEDICARE NUMBER
TXI18008Medicare UPIN
TX00387XMedicare ID - Type Unspecified