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General NPI Number Information
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NPI Number | 1194863662
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Entity Type | Individual
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Provider Name | ALLEN RAY GLASS SR. M.A., L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2007
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 12518 BRAZOS BEND TRL
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City | HUMBLE
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State | TX
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Zip | 77346-3082
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Country | US
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Telephone | 324-922-2078
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Fax |
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Provider Business Mailing Address
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Address Line | 12518 BRAZOS BEND TRL
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City | HUMBLE
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State | TX
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Zip | 77346-3082
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Country | US
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Telephone | 832-492-2207
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 19292
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19292
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License Number State |
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