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NPI Code Detail

MEDICARE: JEFFREY R GLADDEN MD

MEDICARE: JEFFREY R GLADDEN MD
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
1207RC0000XCardiovascular Disease PhysicianH4934TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12316140OTHERTXBLUELINK
2060043414OTHERTXRR MCARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710934385
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY R GLADDEN MD
Provider Business Mailing Address
First Line : 8150 N CENTRAL EXPY
Second Line : STE M1001
City : DALLAS
State : TX
Zip : 75206-1815
Country : US
Telephone Number : 214-221-0022
Fax Number : 214-691-8292
Provider Business Practice Location Address
First Line : 8150 N CENTRAL EXPY
Second Line : SUITE M1001
City : DALLAS
State : TX
Zip : 75206-1815
Country : US
Telephone Number : 214-221-0022
Fax Number : 214-691-8292
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 07/08/2007

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Directions to “ JEFFREY R GLADDEN MD” Practice Location

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