Rountree, Glen A
Rountree, Glen A is an individual health care provider with primary practice located at 1902 Moores Ln , Texarkana TX 75503-4610. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Rountree, Glen A can be contacted via phone (903) 792-7515.Contact Information
Primary practice address
1902 Moores Ln
Texarkana TX 75503-4610
Phone: (903) 792-7515
Fax: (903) 791-8645
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | D5189 | Texas |
Profile Details
| NPI number | 1144222100 |
|---|---|
| LBN Legal business name | Rountree, Glen A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2005 |
| Last updated | Apr 20th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144222100 | NPPES |
| Texas | MEDICAID | 1139225502 |
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