Sorrentino, Glen W

Sorrentino, Glen W is an individual health care provider with primary practice located at 520 East Douglas , Tyler TX 75702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Sorrentino, Glen W can be contacted via phone (903) 593-1721.

Contact Information

Primary practice address
520 East Douglas Tyler TX 75702
Phone: (903) 593-1721
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X M3092 Texas

Profile Details

NPI number 1265407654
LBN Legal business name Sorrentino, Glen W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Oct 14th, 2014 - about 10 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 1265407654 NPPES
Texas Other 751976930005 TRICARE
Texas MEDICAID 178726902 TRICARE
Texas Other 750818167044 TRICARE
Texas Other 750818167015 TRICARE
Texas Other 750818167048 TRICARE
Texas Other 750818167022 TRICARE

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