NPIMap

Organization Active NPI

David W. Glenn M.D. PA

  • Internal Medicine Physician
  • Lufkin, TX
National Provider Identifier
1427186485
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DAVID W. GLENN M.D. PA
Practice address
1111 W Frank Ave Ste 100
Lufkin, TX 75904-3390
Phone
(936) 639-2244
Fax
(936) 634-9334
NPI assigned
Mar 1, 2007
Last updated
Jun 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Authorized official

Name
Dr. David W Glenn, M.D.NPI 1245315498
Title
Physician
Phone
(936) 639-2244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1111 W Frank Ave Ste 100
Lufkin, TX 75904-3390

Mailing address

1111 W Frank Ave Ste 100
Lufkin, TX 75904-3390
Phone (936) 639-2244

Other identifiers 2

IdentifierTypeStateIssuer
0064PYOtherTXBCBS
179088301MedicaidTX

National Provider Directory

National Provider Directory

Locations

1111 W Frank Ave
Ste 100
Lufkin, TX 75904
Phone (936) 639-2244

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1427186485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W FRANK AVE STE 100",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043390",
            "telephone_number": "936-639-2244",
            "fax_number": "936-634-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W FRANK AVE STE 100",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043390",
            "telephone_number": "936-639-2244",
            "fax_number": "936-634-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W. GLENN M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "936-639-2244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0064PY",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179088301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.