Healthcare Provider Details

I. General information

NPI: 1255236592
Provider Name (Legal Business Name): GLYM RIDE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5327 OAK FALLS DR
HOUSTON TX
77066-5139
US

IV. Provider business mailing address

12955 WILLOW PLACE DR W UNIT 690825
HOUSTON TX
77269-0900
US

V. Phone/Fax

Practice location:
  • Phone: 281-770-6443
  • Fax:
Mailing address:
  • Phone: 281-770-6443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number StateNULL

VIII. Authorized Official

Name: BERRY BENSON
Title or Position: MANAGER
Credential:
Phone: 281-770-6443