Individual
SHANNON B. GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
Q1611
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348611003
—
TX
05
—
348611004
—
TX
01
—
667447
MEDICARE
TX
01
—
667934
MEDICARE
TX
01
—
8JP975
BCBS
TX
01
—
8JW906
BCBS
TX
01
—
P02057868
MEDICARE RAIL ROAD
TX
01
—
P02057870
MEDICARE RAIL ROAD
TX
Enumeration date
05/31/2010
Last updated
06/09/2026
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