Individual
GLEN BELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
3463 MAGIC DR, SAN ANTONIO, TX 78229-2973
(210) 614-8101
(210) 614-8102
Mailing address
24915 BIRDIES GRN, SAN ANTONIO, TX 78260-4841
(817) 875-6990
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
FPF00000471
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08501434
DRIVER LICENSE
TX
Enumeration date
04/24/2019
Last updated
04/24/2019
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