MEDICARE: MR. OSCAR CLARK GLICKMAN L.C.S.W.

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	1041C0700X	Clinical Social Worker	32574	TX

General Provider Information

NPI Number	:	1215241823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. OSCAR CLARK GLICKMAN L.C.S.W.

Provider Business Mailing Address
First Line	:	1715 BRIARMEAD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2927
Country	:	US
Telephone Number	:	713-782-5122
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 BRIARMEAD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2927
Country	:	US
Telephone Number	:	713-782-5122
Fax Number	:

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

Provider Enumeration Date	:	08/06/2010
Last Update Date	:	08/06/2010

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