Individual provider Active NPI

Aubrey Glenn Nelms, MT

  • Medical Laboratory Technician
  • Dallas, TX
National Provider Identifier
1821478033
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Laboratory TechnicianTaxonomy code 246RM2200X
License
15735TGS-3 Issued in NV
Practice address
9441 LBJ Fwy
Suite 602
Dallas, TX 75243-4545
Phone
(469) 249-1887
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory Technician 246RM2200X 15735TGS-3 NV Primary

Addresses

Primary practice location

9441 LBJ Fwy
Suite 602
Dallas, TX 75243-4545

Mailing address

9441 LBJ Fwy
Suite 602
Dallas, TX 75243-4545
Phone (469) 249-1887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
15735TGS-3NVMDMedical Laboratory Technician

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1821478033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9441 LBJ FWY",
            "address_2": "SUITE 602",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752434545",
            "telephone_number": "469-249-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9441 LBJ FWY",
            "address_2": "SUITE 602",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752434545",
            "telephone_number": "469-249-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELMS",
        "first_name": "AUBREY",
        "middle_name": "GLENN",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "NV",
            "license": "15735TGS-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.