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Organization

MG ASSOCIATES PA

Active
Other names
Professional Association
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL ALLAN GLICK EDD (LICENSED PSYCHOLOGIST)
(214) 521-0451
Entity
Organization

Contact information

Practice address
3906 LEMMON AVE, SUITE 204, DALLAS, TX 75219-3760
(214) 521-0451
(214) 520-9261
Mailing address
3906 LEMMON AVE, SUITE 204, DALLAS, TX 75219-3760
(214) 521-0451
(214) 520-9261

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
TX214042
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
096785304
TX
Enumeration date
11/07/2006
Last updated
09/15/2009
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