Glass, Mark William

Glass, Mark William is an individual health care provider with primary practice located at 17051 Dallas Pkwy Ste 400 , Addison TX 75001-7108. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Glass, Mark William can be contacted via phone (214) 370-3535.

Contact Information

Primary practice address
17051 Dallas Pkwy Ste 400 Addison TX 75001-7108
Phone: (214) 370-3535
Fax: (214) 370-0004
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA02857 Texas

Profile Details

NPI number 1013021161
LBN Legal business name Glass, Mark William
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013021161 NPPES
Texas MEDICAID 209276607
Texas Other 806N48

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