Organization
PEDIATRIC BEHAVIORAL SPECIALIST OF EAST TEXAS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY GLASS M.D (DR/OWNER)
(936) 634-2214
Entity
Organization
Contact information
Practice address
205 GENE SAMFORD DR, LUFKIN, TX 75904-3359
(936) 634-2214
(936) 639-9660
Mailing address
205 GENE SAMFORD DR, LUFKIN, TX 75904-3359
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
G1593
TX
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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