Provider Demographics
NPI:1871522557
Name:SCARBOROUGH, TERRY K (MD)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:K
Last Name:SCARBOROUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 FANNIN ST.
Mailing Address - Street 2:SUITE 950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5898
Mailing Address - Country:US
Mailing Address - Phone:713-493-7700
Mailing Address - Fax:281-971-4065
Practice Address - Street 1:5115 FANNIN ST.
Practice Address - Street 2:SUITE 950
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5898
Practice Address - Country:US
Practice Address - Phone:713-493-7700
Practice Address - Fax:281-971-4065
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3813208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148986601Medicaid
TX8F6690OtherBCBS
TX8462N7Medicare PIN
TX8F6690OtherBCBS
TX0200515452Medicare PIN