Individual provider Active NPI

Kalli R Glass, DO

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1124715321
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
W5348 Issued in TX
Practice address
11130 Christus Hills
Medical Plaza 3, 3Rd Floor
San Antonio, TX 78251-3585
Phone
(210) 703-9001
Fax
(210) 703-9155
NPI assigned
Apr 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10083958 TX
Family Medicine Physician 207Q00000X W5348 TX Primary

Addresses

Primary practice location

11130 Christus Hills
Medical Plaza 3, 3Rd Floor
San Antonio, TX 78251-3585

Mailing address

11130 Christus Hills
Medical Plaza 3, 3Rd Floor
San Antonio, TX 78251-3585
Phone (210) 703-9001

Other practice location 1

1110 N Sarah DeWitt Dr
Gonzales, TX 78629-3311
Phone (830) 672-8502

Other names 1

  • Kalli Davis Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhgkglass@gonzhealthsys.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260522003389 TX Practitioner - Family Practice 5991151953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311

11130 Christus HLS
FL 3
San Antonio, TX 78251-3584

612 S Fleishel Ave
Tyler, TX 75701-2012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
W5348TXMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: kglass316685@christushealth.direct-ci.net
  • Direct secure messaging: mhgkglass@gonzhealthsys.cernerdirect.com

Organizations & group practices 1

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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1124715321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 CHRISTUS HILLS",
            "address_2": "MEDICAL PLAZA 3, 3RD FLOOR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513585",
            "telephone_number": "210-703-9001",
            "fax_number": "210-703-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 CHRISTUS HILLS",
            "address_2": "MEDICAL PLAZA 3, 3RD FLOOR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513585",
            "telephone_number": "210-703-9001",
            "fax_number": "210-703-9155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 N Sarah DeWitt Dr",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "TX",
            "postal_code": "786293311",
            "country_code": "US",
            "telephone_number": "830-672-8502",
            "fax_number": "830-541-5557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASS",
        "first_name": "KALLI",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10083958",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "W5348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhgkglass@gonzhealthsys.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Microsoft word",
            "address_1": "1110 N Sarah DeWitt Dr",
            "city": "Gonzales",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786293311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KALLI",
            "last_name": "DAVIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.