Organization
DEDICATED HEALTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL MARIE GLENN (OWNER)
(360) 907-7534
Entity
Organization
Contact information
Practice address
6868 SAN PEDRO AVE, SAN ANTONIO, TX 78216-7201
(872) 215-0361
(877) 384-2623
Mailing address
21260 S SPRINGWATER RD, ESTACADA, OR 97023-9650
(306) 907-7534
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207YS0012X
Sleep Medicine (Otolaryngology) Physician
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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