MEDICARE: GLORY HEALTH SERVICES INC

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	324500000X	Substance Abuse Rehabilitation Facility	2422-B	TX
2	103TC1900X	Counseling Psychologist	2422-A	TX

General Provider Information

NPI Number	:	1811905193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLORY HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	2600 SOUTH LOOP W STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2603
Country	:	US
Telephone Number	:	713-530-7867
Fax Number	:	713-669-8866

Provider Business Practice Location Address
First Line	:	2600 SOUTH LOOP W STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2603
Country	:	US
Telephone Number	:	713-530-7867
Fax Number	:	713-669-8866

Authorized Official
Title or Position	:	C.E.O/ DIRECTOR
Name	:	MR. VINCENT E UZOMAH
Credential	:
Telephone Number	:	713-530-7867

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	09/11/2025

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Directions to “GLORY HEALTH SERVICES INC ” Practice Location

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