Individual
GLENN LEE PRIDE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 645-2300
(214) 645-2301
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-2300
(214) 645-2301
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
J0635
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117208203
—
TX
Enumeration date
04/18/2006
Last updated
12/17/2018
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