Glen Rose Medical Clinic, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F4491 Issued in TX

Legal business name

GLEN ROSE MEDICAL CLINIC, PA

Practice address

1008 N E Big Bend Trail
Glen Rose, TX 76043-0728

Phone

(254) 897-3310

Fax

(254) 898-0495

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark W Schneider, MD

Title

Owner

Phone

(254) 897-1613

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1255465027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760430728",
            "telephone_number": "254-897-3310",
            "fax_number": "254-897-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N E BIG BEND TRAIL",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760430728",
            "telephone_number": "254-897-3310",
            "fax_number": "254-898-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN ROSE MEDICAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-897-1613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F4491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen Rose Family Dental
• Glen Rose Healthcare, Inc
• Glen Rose I Enterprises, LLC (Cherokee Rose Nursing and Rehabilitation)
• Glen Rose Isd
• Glen Rose Medical Center Nursing Home, LLC
• Glen Rose Medical Foundation (Glen Rose Medical Center)
• Glen Rose Medical Foundation (Glen Rose Medical Center)
• Glen Rose Medical Foundation Inc. (Glen Rose Medical Center)
• Glen Rose Physical Therapy and Sports Rehab, P.C.
• Joanna Labette Golliday

• Family Medicine Physician in Glen Rose, TX
• Providers in Glen Rose, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.