Glass, Shannon B.

Glass, Shannon B. is an individual health care provider with primary practice located at 11937 Us Highway 271 , Tyler TX 75708. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Glass, Shannon B. can be contacted via phone (903) 877-7777.

Contact Information

Primary practice address
11937 Us Highway 271 Tyler TX 75708
Phone: (903) 877-7777
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X Q1611 Texas

Profile Details

NPI number 1982923975
LBN Legal business name Glass, Shannon B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2010
Last updated Aug 28th, 2023 - about 2 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 1982923975 NPPES
Texas Other P02057868 MEDICARE RAIL ROAD
Texas Other 8JW906 MEDICARE RAIL ROAD
Texas Other P02057870 MEDICARE RAIL ROAD
Texas MEDICAID 348611003 MEDICARE RAIL ROAD
Texas MEDICAID 348611004 MEDICARE RAIL ROAD
Texas Other 667447 MEDICARE RAIL ROAD
Texas Other 667934 MEDICARE RAIL ROAD
Texas Other 8JP975 MEDICARE RAIL ROAD

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