MEDICARE: MRS. PASQUINEL G GLENN PA

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	363A00000X	Physician Assistant	2004000619	MO
2	363A00000X	Physician Assistant		TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P01095021	OTHER	TX	RAIL ROAD MEDICARE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	890N47	OTHER	TX	BCBS
5	886N28	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1912925603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PASQUINEL G GLENN PA

Provider Business Mailing Address
First Line	:	18223 WINDING WILLOW OAK WAY
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-8037
Country	:	US
Telephone Number	:	281-357-0111
Fax Number	:

Provider Business Practice Location Address
First Line	:	13300 HARGRAVE RD STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4374
Country	:	US
Telephone Number	:	281-357-0111
Fax Number	:

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	02/07/2024

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Directions to “ MRS. PASQUINEL G GLENN PA” Practice Location

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