MEDICARE: GLENN B. ANDERSON 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
1	207T00000X	Neurological Surgery Physician	14085R	LA
2	207T00000X	Neurological Surgery Physician	N2379	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	:	1750370102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENN B. ANDERSON MD

Provider Business Mailing Address
First Line	:	6560 FANNIN ST
Second Line	:	STE 944
City	:	HOUSTON
State	:	TX
Zip	:	77030-2761
Country	:	US
Telephone Number	:	713-441-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	13300 HARGRAVE RD
Second Line	:	SUITE 390
City	:	HOUSTON
State	:	TX
Zip	:	77070-4373
Country	:	US
Telephone Number	:	281-737-2932
Fax Number	:

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	12/03/2014

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Directions to “ GLENN B. ANDERSON MD” Practice Location

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