Active NPI
Glen A Rountree, MD
- Urology Physician
- Texarkana, TX
National Provider Identifier
1144222100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- D5189
- Practice address
- 1902 Moores LN
Texarkana, TX 75503-4610 - Phone
- (903) 792-7515
- Fax
- (903) 791-8645
- NPI assigned
- Jun 2, 2005
- Last updated
- Apr 20, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | D5189 | TX | Primary |
Addresses
Primary practice location
1902 Moores LN
Texarkana, TX 75503-4610
Mailing address
5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Phone (903) 614-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1139225502 | Medicaid | TX |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- glen.rountree.p1@direct.collom-carney.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303257600000",
"number": "1144222100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5002 COWHORN CREEK RD",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755039766",
"telephone_number": "903-614-3000",
"fax_number": "903-614-3525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1902 MOORES LN",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755034610",
"telephone_number": "903-792-7515",
"fax_number": "903-791-8645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUNTREE",
"first_name": "GLEN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-02",
"last_updated": "2011-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TX",
"license": "D5189",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1139225502",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
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- Roshan Sharma, M.D., P.a.
- Amanda Michelle Ross, FNP-C
- Terri A Rowe, LMSW
- Royael Health Care Services, Inc. (Royael Health Care)
- Morgen Melinda Rozenboom, M.D.
- Runnin WJ Therapeutic Center Inc
- Rush Family Health Care, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.