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Individual

DAVID WREN GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1111 W FRANK AVE, SUITE 100, LUFKIN, TX 75904-3303
(936) 639-2244
(936) 634-9334
Mailing address
1111 W FRANK AVE, SUITE 100, LUFKIN, TX 75904-3303
(936) 639-2244
(936) 634-9334

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H0057
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8AJ182
BLUE CROSS
TX
Enumeration date
10/26/2006
Last updated
03/06/2008
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