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General NPI Number Information
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NPI Number | 1366787061
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Entity Type | Organization
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Legal Business Name | JEFFREY ADELGLASS MD PA
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 6020 W PARKER RD STE 400
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City | PLANO
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State | TX
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Zip | 75093-8175
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Country | US
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Telephone | 972-492-6990
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Fax | 469-298-1488
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Provider Business Mailing Address
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Address Line | 6020 W PARKER RD STE 400
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City | PLANO
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State | TX
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Zip | 75093-8175
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Country | US
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Telephone | 972-492-6990
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Fax | 469-298-1488
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY MARC ADELGLASS
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Credential | MD
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Telephone | 972-492-6990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | F8786
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License Number State | TX
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