Individual provider Active NPI

Shannon Diane Glaser, RPH

  • Pharmacist
  • Flower Mound, TX
National Provider Identifier
1851685887
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
42166 Issued in TX
Practice address
5959 Long Prairie Rd
Flower Mound, TX 75028-2224
Phone
(972) 874-6709
Fax
(972) 874-6709
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42166 TX Primary

Addresses

Primary practice location

5959 Long Prairie Rd
Flower Mound, TX 75028-2224

Mailing address

5959 Long Prairie Rd
Flower Mound, TX 75028-2224
Phone (972) 874-6709

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
42166TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1851685887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 LONG PRAIRIE RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282224",
            "telephone_number": "972-874-6709",
            "fax_number": "972-874-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 LONG PRAIRIE RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282224",
            "telephone_number": "972-874-6709",
            "fax_number": "972-874-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "SHANNON",
        "middle_name": "DIANE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "42166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.