Healthcare Provider Details

I. General information

NPI: 1336325190
Provider Name (Legal Business Name): TANYA ANNE GLASS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32141 CARDAMOM WAY
BULVERDE TX
78163-4047
US

IV. Provider business mailing address

32141 CARDAMOM WAY
BULVERDE TX
78163-4047
US

V. Phone/Fax

Practice location:
  • Phone: 210-993-5398
  • Fax:
Mailing address:
  • Phone: 210-993-5398
  • Fax: 830-310-8278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number123393
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number123393
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: