Active NPI
Glen Williams Jr, RT.R.CT.CV.MR
- Cardiac-Interventional Technology Radiologic Technologist
- Houston, TX
National Provider Identifier
1063512432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiac-Interventional Technology Radiologic Technologist
- License
- 212190
- Practice address
- 16107 Beechnut St
Houston, TX 77083 - Phone
- (713) 791-1414
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiac-Interventional Technology Radiologic Technologist | 2471C1106X | 212190 | TX | Primary |
Addresses
Primary practice location
16107 Beechnut St
Houston, TX 77083
Mailing address
16107 Beechnut St
Houston, TX 77083
Phone (713) 791-1414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212190 | TX | MD | Cardiac-Interventional Technology Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063512432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16107 BEECHNUT ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77083",
"telephone_number": "713-791-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16107 BEECHNUT ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77083",
"telephone_number": "713-791-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS JR",
"first_name": "GLEN",
"credential": "RT.R.CT.CV.MR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2471C1106X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Cardiac-Interventional Technology",
"state": "TX",
"license": "212190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
- William Nassib William, M.D.
- Tamara Denyse Williams Benjamin, LPC
- Williams Caring Hearts, Inc
- Samarria Williams Davis, BSHA, MPA
- Andres Kenneth Williams Gonzalez
- Toni Williams Keaton, MD
- Williams Legacy Unlimited LLC
- Imane Williams Newsome, APRN- PMHNP
- Sarah Grace Williams Viana
- Shawanda Williams-Anderson, PH. D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.