Individual
DR. JEFFREY GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12810 HILLCREST RD, SUITE B220, DALLAS, TX 75230-1525
(214) 696-9270
Mailing address
12810 HILLCREST RD, SUITE B220, DALLAS, TX 75230-1525
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G4298
TX
2084P0805X
Geriatric Psychiatry Physician
G4298
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002735-01
—
TX
Enumeration date
10/17/2006
Last updated
07/12/2007
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