Wallace A Gleason, M.D.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

E9659 Issued in TX

Practice address

6410 Fannin St
500
Houston, TX 77030-3000

Phone

(832) 325-7111

Fax

(713) 512-2230

NPI assigned

Jun 15, 2006

Last updated

Aug 3, 2016By the provider in NPPES

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

Other identifiers 3

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wgleason15019@direct.uth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821

  Pediatrics

  Medicare reassignment NPD
• Ut Physicians

  dba UT Health Services

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1750325536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301173",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753031173",
            "telephone_number": "713-500-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST",
            "address_2": "500",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303000",
            "telephone_number": "832-325-7111",
            "fax_number": "713-512-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "WALLACE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "E9659",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "E9659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "137015705",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137015708",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88Y666",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariel Glaze, NCC, LPC
• Paityn T Glaze, PHARMD
• Gary Lamont Glazebrook Jr., PHARM. D
• Melanie Gleason, LCSW-S
• Michael William Gleason, MD
• Peggy Blake Gleeson, PT
• Glen L Bruenjes DDS PLLC
• Glencris Construction Inc.
• Glenn L. Morgan M.D.,PA
• Alexandra Glenn, LPC, LCDC

• Pediatric Gastroenterology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.