Individual
JAMES RANDALL GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4224 TEXAS BLVD, TEXARKANA, TX 75503-3013
(903) 794-3711
(903) 794-3713
Mailing address
PO BOX 6986, TEXARKANA, TX 75505-6986
(903) 794-3711
(903) 794-3713
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6891T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538172267
NPI
TX
01
—
49979
AR BCBS
TX
01
—
6891T
STATE LICENSE
TX
01
—
81614Q
TX BCBS
TX
Enumeration date
08/14/2006
Last updated
05/21/2008
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