Organization
CHILDREN'S CLINIC OF CROCKETT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY L GLASS MD (PARTNER)
(936) 634-2214
Entity
Organization
Contact information
Practice address
951 E LOOP 304, CROCKETT, TX 75835-5403
(936) 634-2214
(936) 634-2301
Mailing address
PO BOX 150638, LUFKIN, TX 75915-0638
(936) 634-2214
(936) 634-2301
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
01/10/2019
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