Individual
GLEN D. PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8140 N MOPAC EXPY STE 3-210, AUSTIN, TX 78759-8862
(512) 343-2292
(512) 343-2745
Mailing address
8140 N MOPAC EXPY STE 3-210, AUSTIN, TX 78759-8862
(512) 343-2292
(512) 343-2745
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
033763
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023889-02
—
TX
01
—
87217U
BCBS OF TX
TX
Enumeration date
06/15/2006
Last updated
06/04/2008
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