MEDICARE: DR. DANIELLE R GLOSTER MORRIS O.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
1	152W00000X	Optometrist	7670TG	TX

General Provider Information

NPI Number	:	1720384498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE R GLOSTER MORRIS O.D.

Provider Business Mailing Address
First Line	:	1233 E PLEASANT RUN RD STE A
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-4200
Country	:	US
Telephone Number	:	972-223-2020
Fax Number	:	972-223-1860

Provider Business Practice Location Address
First Line	:	1233 E PLEASANT RUN RD STE A
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-4200
Country	:	US
Telephone Number	:	972-223-2020
Fax Number	:	972-228-1860

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

Provider Enumeration Date	:	01/28/2011
Last Update Date	:	05/02/2023

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