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General NPI Number Information
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NPI Number | 1558364588
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Entity Type | Individual
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Provider Name | GLEN GARNER MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 11914 ASTORIA BLVD STE 575
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City | HOUSTON
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State | TX
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Zip | 77089-6080
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Country | US
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Telephone | 281-929-4420
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Fax | 281-929-4421
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Provider Business Mailing Address
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Address Line | 11920 ASTORIA BLVD SUITE 350
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City | HOUSTON
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State | TX
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Zip | 77089-6097
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Country | US
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Telephone | 281-929-4420
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Fax | 281-929-4421
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | K4689
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | K4689
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License Number State | TX
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