Individual
ANDREA M GLASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3593 E GRANDE BLVD, TYLER, TX 75707-1400
(903) 539-2585
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
P1647
TX
2080P0206X
Pediatric Gastroenterology Physician
Primary
P1647
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P1647
TX MEDICAL LICENSE NUMBER
TX
Enumeration date
07/13/2012
Last updated
06/26/2024
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