Healthcare Provider Details
I. General information
NPI: 1730118332
Provider Name (Legal Business Name): CLAUDIA H. GLASS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/03/2006
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8811 VILLAGE DR SUITE 300
SAN ANTONIO TX
78217-5415
US
IV. Provider business mailing address
TEXAS CENTER FOR MEDICAL AND SURGICAL WEIGHT LOSS 8811 VILLAGE DR., SUITE 300
SAN ANTONIO TX
78217-5415
US
V. Phone/Fax
- Phone: 210-651-3033
- Fax: 210-651-0302
- Phone: 210-651-0303
- Fax: 210-651-0302
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 549256 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: