Individual provider Active NPI

Dale S. Glass, M.D.

  • Diagnostic Radiology Physician
  • Temple, TX
National Provider Identifier
1184684888
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
H6245 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-0001
Phone
(254) 724-2111
Fax
(254) 724-7603
NPI assigned
Mar 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X H6245 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-0001

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other identifiers 3

IdentifierTypeStateIssuer
1392961-03MedicaidTX
82948NOtherTXBLUE SHIELD
300124839OtherTXRR/MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dglass10915@direct.sw.org 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
I20091231000163 TX Practitioner - Diagnostic Radiology 6800937665 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at Houston, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1280 Arrington Rd
Suite 200
College Station, TX 77845-8696
Phone (979) 207-6550

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1700 University Dr E
College Station, TX 77840-2661
Phone (979) 691-3300

1700 University Dr E Entrance 16
Care Clinic College Station University Dr
College Station, TX 77840-2661
Phone (979) 207-3636

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

2849 Barron Rd
College Station, TX 77845-9171
Phone (979) 207-6800

700 Medical Pkwy
Brenham, TX 77833-5413
Phone (979) 836-6173

700 Scott and White Dr
College Station, TX 77845-6441
Phone (979) 207-0100

800 Scott and White Dr
College Station, TX 77845-6440
Phone (979) 207-4000

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H6245TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Scott & White Clinic Diagnostic Radiology CurrentSince Jul 1, 1999 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Scott & White Clinic Diagnostic Radiology CurrentSince Jul 1, 1999 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

800 Scott and White Dr
College Station, TX 77845
Phone (979) 207-3300

1600 University Dr E
College Station, TX 77840
Phone (409) 691-3300

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

700 Scott and White Dr
College Station, TX 77845
Phone (979) 207-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1184684888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-2111",
            "fax_number": "254-724-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "DALE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "H6245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1392961-03",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "82948N",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "300124839",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dglass10915@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31ST ST",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.