Glow Land Company, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

GLOW LAND COMPANY, LLC

Practice address

1618 S Buckner Blvd
Dallas, TX 75217-1707

Phone

(469) 248-0090

Fax

(214) 930-1084

NPI assigned

Feb 27, 2023

Last updated

Feb 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yunier Mendez Pupo

Title

Administrator

Phone

(469) 248-0090

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Antonio Brizuela Aguilar

  • Family Nurse Practitioner
  • Grand Prairie, TX
  • NPI 1588279533
  Medicare reassignment NPD

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1952000226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 S BUCKNER BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752171707",
            "telephone_number": "469-248-0090",
            "fax_number": "214-930-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 S BUCKNER BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752171707",
            "telephone_number": "469-248-0090",
            "fax_number": "214-930-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW LAND COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "MENDEZ PUPO",
        "authorized_official_first_name": "YUNIER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "469-248-0090"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://app.kareo.com/login-ui/#/login",
            "affiliation": "N",
            "address_1": "1618 S Buckner Blvd",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752171707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark Erwin Glover, D.D.S.,M.S.D.
• Suzanne Glover
• Tenasia Glover
• Glovis Home Health Services, Inc
• Glow Dental and Orthodontics PLLC
• Go Fearless, PLLC
• Go Just for Kids
• Go Rehab, PA
• Christian Robert Rufus Goans, PHD
• Jessica Ashley Gober, OTR

• Family Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.