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NPI Code Detail

MEDICARE: DR. DAVID GLENN NELSON M.D.

MEDICARE: DR. DAVID GLENN NELSON M.D.
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
1173000000XLegal MedicineH6465TX
2207Q00000XFamily Medicine PhysicianH6465TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MDH6465OTHERTXWORKER'S COMP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396752259
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID GLENN NELSON M.D.
Provider Business Mailing Address
First Line : 9055 KATY FWY STE 200
Second Line :
City : HOUSTON
State : TX
Zip : 77024-1629
Country : US
Telephone Number : 713-461-2915
Fax Number : 713-461-5307
Provider Business Practice Location Address
First Line : 9511 HUFFMEISTER ROAD
Second Line : 100
City : HOUSTON
State : TX
Zip : 77095-2865
Country : US
Telephone Number : 713-461-2915
Fax Number : 713-461-5307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 05/01/2018

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