MEDICARE: CHRISTOPHER JAMES GLENN M.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	207VX0000X	Obstetrics Physician	J5579	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	:	1992786149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JAMES GLENN M.D.

Provider Business Mailing Address
First Line	:	19701 KINGWOOD DR BLDG 5
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-3773
Country	:	US
Telephone Number	:	281-319-4111
Fax Number	:	281-319-4623

Provider Business Practice Location Address
First Line	:	19701 KINGWOOD DR BLDG 5
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-3773
Country	:	US
Telephone Number	:	281-319-4111
Fax Number	:	281-319-4623

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	03/10/2014

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