MEDICARE: MR. GLENN OTAKE RPH

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
1	183500000X	Pharmacist	28645	TX

General Provider Information

NPI Number	:	1134460009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GLENN OTAKE RPH

Provider Business Mailing Address
First Line	:	8523 BRAUN KNL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-5584
Country	:	US
Telephone Number	:	210-844-9426
Fax Number	:

Provider Business Practice Location Address
First Line	:	9238 N LOOP 1604 W
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2577
Country	:	US
Telephone Number	:	210-682-3419
Fax Number	:	210-521-5184

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2013
Last Update Date	:	03/01/2013

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1134528938 — DR. PAUL GERARD MILLER D.C.
Practice Location Address:

9238 N LOOP 1604 W , SUITE 101
SAN ANTONIO, TX
78249-2577

Practice Phone: 210-251-3514
Practice Fax:

1841737590 — DR. STEOHEN WELLS PHARMD
Practice Location Address:

9238 N LOOP 1604 W
SAN ANTONIO, TX
78249-2577

Practice Phone: 210-682-3419
Practice Fax:

1649212713 — GINGER L. GRAY LCSW
Practice Location Address:

19115 FM 2252 , STE 12
SAN ANTONIO, TX
78266-2577

Practice Phone: 210-573-5034
Practice Fax: 210-545-2504

1790033512 — GERARDO E. CARCAMO, MD PA
Practice Location Address:

414 NAVARRO ST , SUITE 810
SAN ANTONIO, TX
78205-2577

Practice Phone: 210-220-1726
Practice Fax: 210-224-3058

1568716611 — MRS. AMY LYNN QUILLIN M.A., NCC
Practice Location Address:

19115 FM 2252 , SUITE 12
SAN ANTONIO, TX
78266-2577

Practice Phone: 210-236-7768
Practice Fax:

Directions to “ MR. GLENN OTAKE RPH” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.