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NPI Code Detail

MEDICARE: DR. SUSANA ESCALANTE-GLORSKY M.D.

MEDICARE:  DR. SUSANA  ESCALANTE-GLORSKY  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistL1029TX
2207RG0100XGastroenterology Physician2015019922MO

General Provider Information

NPI Number : 1043214760
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSANA ESCALANTE-GLORSKY M.D.
Provider Business Mailing Address
First Line : PO BOX 504407
Second Line :
City : ST LOUIS
State : MO
Zip : 63150
Country : US
Telephone Number : 816-502-7000
Fax Number :
Provider Business Practice Location Address
First Line : 801 E. NOLANA AVE
Second Line : STE 4
City : MCALLEN
State : TX
Zip : 78504-6113
Country : US
Telephone Number : 956-686-2626
Fax Number : 956-686-1616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 10/07/2015

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Directions to “ DR. SUSANA ESCALANTE-GLORSKY M.D.” Practice Location

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