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Contact Information

DEMETRIUS TERRY JR
4106 S 130TH EAST PL
TULSA, OK74134
 Phone: 918-230-9789
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for DEMETRIUS TERRY JR · (Male)

NPI Number 1285574863
Status Active
Credentials
Entity Individual
Enumeration date 03/31/2026
Last updated 03/31/2026 - About 2 months ago
Sole proprietor 1 Yes
Identifiers
  • OK License # Z309380073
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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