MEDICARE: DR. MICHAEL AUSTIN GLASS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	34493	CO
2	208800000X	Urology Physician	DR.0034493	CO

General Provider Information

NPI Number	:	1164425047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL AUSTIN GLASS MD

Provider Business Mailing Address
First Line	:	11960 LIONESS WAY
Second Line	:	SUITE 210
City	:	PARKER
State	:	CO
Zip	:	80134-0000
Country	:	US
Telephone Number	:	303-695-8706
Fax Number	:	303-695-1211

Provider Business Practice Location Address
First Line	:	11960 LIONESS WAY
Second Line	:	SUITE 210
City	:	PARKER
State	:	CO
Zip	:	80134-0000
Country	:	US
Telephone Number	:	303-695-8706
Fax Number	:	303-695-1211

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/11/2025

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Directions to “ DR. MICHAEL AUSTIN GLASS MD” Practice Location

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