Individual provider Active NPI

Glenn Martin Haluska, M.D.

  • Radiation Oncology Physician
  • Waco, TX
National Provider Identifier
1083634877
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
F2275 Issued in TX
Practice address
3000 Herring Ave
Waco, TX 76708-3239
Phone
(254) 202-8675
Fax
(254) 202-6669
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X F2275 TX Primary

Addresses

Primary practice location

3000 Herring Ave
Waco, TX 76708-3239

Mailing address

2100 Ridgewood Dr
Waco, TX 76710-6103
Phone (254) 772-3701

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F2275TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Advanced Medical Imaging LP Past Accepting new patients
Hillcrest X-Ray Physicians Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083634877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 RIDGEWOOD DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767106103",
            "telephone_number": "254-772-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HERRING AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083239",
            "telephone_number": "254-202-8675",
            "fax_number": "254-202-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALUSKA",
        "first_name": "GLENN",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "F2275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

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.

Verify at the official NPI Registry.