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General NPI Number Information
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NPI Number | 1518004423
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Entity Type | Individual
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Provider Name | ROSALIND MARIE GLENN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3304 SE LOOP 820
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City | FORT WORTH
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State | TX
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Zip | 76140-1108
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Country | US
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Telephone | 817-483-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 4209 EAGLE RIDGE DR
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City | ARLINGTON
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State | TX
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Zip | 76016-4615
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Country | US
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Telephone | 817-438-1070
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H0058
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License Number State | TX
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