Individual
BRANDON JOHN GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
600 ELIZABETH ST, CORPUS CHRISTI, TX 78404-2235
(361) 881-3000
(361) 881-3149
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12366
TX
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
09/12/2018
Last updated
07/28/2020
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