Individual
DR. DALE S. GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
(254) 724-7603
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
H6245
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1392961-03
—
TX
01
—
300124839
RR/MEDICARE
TX
01
—
82948N
BLUE SHIELD
TX
Enumeration date
03/25/2006
Last updated
12/16/2021
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