Brandon John Glenn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12366 Issued in TX

Practice address

600 Elizabeth St
Corpus Christi, TX 78404-2235

Phone

(361) 881-3000

Fax

(361) 881-3149

NPI assigned

Sep 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Bexar Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1548034994
  Medicare reassignment
• Elite Hospital Partners, PLLC

  • Emergency Medicine Physician
  • Allen, TX
  • NPI 1609625995
  Medicare reassignment
• Urgent Specialty Associates of Texas, PLLC

  • Surgical Critical Care Physician
  • Kingwood, TX
  • NPI 1790350445
  Medicare reassignment

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1417430679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042235",
            "telephone_number": "361-881-3000",
            "fax_number": "361-881-3149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1309 Oak Hollow Dr",
            "address_purpose": "LOCATION",
            "city": "Dickinson",
            "state": "TX",
            "postal_code": "775393311",
            "country_code": "US",
            "telephone_number": "936-334-4894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENN",
        "first_name": "BRANDON",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-12",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12366",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily May Gleason
• Patrick Langham Gleason, M.D.
• Sarah Courtney Gleinser
• Glenda Jean Peters-DO, M.D., P.a.
• Glenn R Miller DPM
• Joe Gloria
• Jordan N Glover, CRNA
• Julianne S Glover, AGNP-C
• Lee C. Glover, PHYSICAL THERAPIST
• Go-Joe Trucking LLC

• Physician Assistant in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.