Physician Compare National (NPI:1720023070)

HEALTHCARE PROVIDER: GLYNN JOHN PICKENS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1720023070
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557306487
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060118000532
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PICKENS
	Individual professional last name
Provider First Name	GLYNN
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	UROLOGY CLINICS OF NORTH TEXAS, PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	5496736415
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	48
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	890 ROCKWALL PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 110
	Group Practice or individual's line 2 address
City	ROCKWALL
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	750326871
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9729619482
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450537
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	METHODIST RICHARDSON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450742
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAYLOR SCOTT AND WHITE MEDICAL CENTER LAKE POINTE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450352
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HUNT REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	670044
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y