Active NPI
Andrea M Glaser, MD
- Pediatric Gastroenterology Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- P1647
- Practice address
- 3593 E Grande Blvd
Tyler, TX 75707-1400 - Phone
- (903) 539-2585
- NPI assigned
- Jul 13, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | P1647 | TX | |
| Pediatric Gastroenterology Physician | 2080P0206X | P1647 | TX | Primary |
Addresses
Primary practice location
3593 E Grande Blvd
Tyler, TX 75707-1400
Mailing address
PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400
Other practice location 1
301 University Blvd
Galveston, TX 77555-0351
Phone (409) 772-1596
Other practice location 2
800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 606-7264
Other practice location 3
1120 E Front St
Tyler, TX 75702-8414
Phone (903) 606-3630
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P1647 | Other | TX | TX MEDICAL LICENSE NUMBER |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1647 | TX | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utmb Faculty Group Practice | Pediatrics | Current | Accepting new patients |
| Christus Trinity Clinic Texas | Pediatrics | Current | Accepting new patients |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Shriners Hospitals for Children | Current | Accepting new patients | |
| Shriners Hospitals for Children | Current | Accepting new patients |
Locations
815 Market St
Galveston, TX 77550
Phone (409) 770-6600
301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883
511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001
1120 E Front St
Tyler, TX 75702
Phone (903) 597-7902
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018
3593 E Grande Blvd
Tyler, TX 75707
Phone (903) 606-1664
Interoperability endpoints
- aglaser260832@christushealth.direct-ci.net
Organizations & group practices 5
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.
-
- Pediatric Surgery Physician
- Galveston, TX
- NPI 1851631709
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- Clinic/Center
- Aiea, HI
- NPI 1568299857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1659626802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 846098",
"city": "DALLAS",
"state": "TX",
"postal_code": "752846098",
"telephone_number": "903-324-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3593 E GRANDE BLVD",
"city": "TYLER",
"state": "TX",
"postal_code": "757071400",
"telephone_number": "903-539-2585"
}
],
"practiceLocations": [
{
"address_1": "301 University Blvd",
"address_purpose": "LOCATION",
"city": "Galveston",
"state": "TX",
"postal_code": "775550351",
"country_code": "US",
"telephone_number": "409-772-1596",
"fax_number": "409-747-4995",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "800 E Dawson St",
"address_purpose": "LOCATION",
"city": "Tyler",
"state": "TX",
"postal_code": "757012036",
"country_code": "US",
"telephone_number": "903-606-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1120 E Front St",
"address_purpose": "LOCATION",
"city": "Tyler",
"state": "TX",
"postal_code": "757028414",
"country_code": "US",
"telephone_number": "903-606-3630",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLASER",
"first_name": "ANDREA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-13",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "P1647",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "TX",
"license": "P1647",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX MEDICAL LICENSE NUMBER",
"identifier": "P1647",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.