Healthcare Provider Details

I. General information

NPI: 1497513865
Provider Name (Legal Business Name): JAMES GLOVER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 PRAIRIE LANDING LN
KATY TX
77494-1627
US

IV. Provider business mailing address

4007 PRAIRIE LANDING LN
KATY TX
77494-1627
US

V. Phone/Fax

Practice location:
  • Phone: 281-686-8917
  • Fax:
Mailing address:
  • Phone: 281-686-8917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: