NPIMap

Organization Active NPI

Supportive Care of Texas PC

  • Nurse Practitioner
  • Garland, TX
National Provider Identifier
1174247126
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SUPPORTIVE CARE OF TEXAS PC
Practice address
505 W Centerville Rd
Garland, TX 75041-5445
Phone
(718) 298-2753
NPI assigned
Oct 3, 2022
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Robert GlennNPI 1902033210
Title
Director
Phone
(718) 298-4375

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

505 W Centerville Rd
Garland, TX 75041-5445

Mailing address

27 Randolph Rd
Howell, NJ 07731-8611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230224000479 TX Part B Supplier - Clinic/Group Practice 1658744503 Receives reassigned benefits from 38 practitioners
Practice locations: Mesquite, TX; Mineral Wells, TX; Mount Pleasant, TX; Orange, TX; Quinlan, TX; Sachse, TX; Seymour, TX; Sherman, TX…

National Provider Directory

National Provider Directory

Locations

10133 Highway 16
Comanche, TX 76442
Phone (254) 879-4970

25150 Lakecrest Manor Dr
Katy, TX 77493
Phone (281) 347-8200

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1174247126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 RANDOLPH RD",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077318611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W CENTERVILLE RD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415445",
            "telephone_number": "718-298-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE CARE OF TEXAS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-03",
        "last_updated": "2025-09-11",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-298-4375"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.