MEDICARE: DR. GLENN C SAMMIS LPC

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	101YP2500X	Professional Counselor	8122	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629083381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GLENN C SAMMIS LPC

Provider Business Mailing Address
First Line	:	8546 BROADWAY
Second Line	:	SUITE 270
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-6340
Country	:	US
Telephone Number	:	210-860-0888
Fax Number	:	210-826-6106

Provider Business Practice Location Address
First Line	:	8546 BROADWAY
Second Line	:	SUITE 270
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-6340
Country	:	US
Telephone Number	:	210-860-0888
Fax Number	:	210-826-6106

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

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	07/08/2007

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