Vidro Industries, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

062989 Issued in GA

Legal business name

VIDRO INDUSTRIES, LLC

Practice address

20 Herrell Rd
Villa Rica, GA 30180-5527

Phone

(770) 456-4691

NPI assigned

Feb 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Richard Glass Jr., M.D.NPI 1780820753

Title

Ceo

Phone

(770) 456-4691

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Glass, M.D.

  • Family Medicine Physician
  • Villa Rica, GA
  • NPI 1780820753
  NPD Authorized official

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1427355106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301806149",
            "telephone_number": "770-456-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527",
            "telephone_number": "770-456-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDRO INDUSTRIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "GLASS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-456-4691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "062989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344112558A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Vera, MD
• Merna Michelle Vera, MD
• Veranet Healthcare, LLC
• El Janeo D Vereen
• Victory Nursing & Home Care, Inc.
• Vidro Industries, LLC
• Villa Rica Behavioral Health PC
• Villa Rica Dental Smiles LLC
• Villa Rica Family Dental
• Villa Rica OB GYN Inc

• Family Medicine Physician in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.