Individual
DR. GLEN EDWARD HOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0865
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
F1657
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050065906
RAILROAD
TX
05
—
131684602
—
TX
05
—
131684603
—
TX
05
—
131684607
—
TX
05
—
131684608
—
TX
05
—
131684609
—
TX
05
—
131684610
—
TX
05
—
131684611
—
TX
05
—
131684612
—
TX
01
—
83751K
BCBS
TX
01
—
8EH086
BCBS TX
TX
Enumeration date
12/19/2005
Last updated
06/29/2020
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