Individual
GEORGE RUSSELL GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
2825 OAK LAWN AVE UNIT 192749, DALLAS, TX 75219-4688
(510) 683-9500
Mailing address
2825 OAK LAWN AVE UNIT 192749, DALLAS, TX 75219-4688
(510) 683-9500
(877) 880-2039
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036165017
IL
2085R0202X
Diagnostic Radiology Physician
4301515727
MI
2085R0202X
Diagnostic Radiology Physician
95127
GA
2085R0202X
Diagnostic Radiology Physician
Primary
ME176998
FL
Other
Enumeration date
06/15/2018
Last updated
01/05/2026
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