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Individual

DR. GLENN JOSEPH WILCOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3300 DOUGLAS AVE, DALLAS, TX 75219
(214) 526-3336
(214) 526-3337
Mailing address
3300 DOUGLAS AVE, DALLAS, TX 75219
(214) 526-3336
(214) 526-3337

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1394
TX
213E00000X
Podiatrist
963253170501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
F00104E9
TX
Enumeration date
11/14/2006
Last updated
07/08/2007
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