Healthcare Provider Details

I. General information

NPI: 1124983341
Provider Name (Legal Business Name): GLORI ANN COSIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14426 MEDICAL COMPLEX DR STE 106
TOMBALL TX
77377-3101
US

IV. Provider business mailing address

16614 E LYNBROOK
MONTGOMERY TX
77316-2946
US

V. Phone/Fax

Practice location:
  • Phone: 281-205-8421
  • Fax:
Mailing address:
  • Phone: 281-205-8421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number937839
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: