GLEN LAKES OB GYN PA NPI 1124203229

NPI Information

NPI: 1124203229
Provider Name: GLEN LAKES OB GYN PA
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
997 RAINTREE CIR
SUITE 170
ALLEN, TX
ZIP 75013
Phone: (214) 692-8660
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GLEN LAKES OB GYN PA is a specialist in Allen, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GLEN LAKES OB GYN PA NPI is 1124203229. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

997 RAINTREE CIR
SUITE 170
ALLEN, TX
ZIP 75013-949
Phone: (214) 692-8660
Fax: (214) 692-8096

The provider's authorized official is Robert Scott Darrow .
The authorized official title is Owner and has the following contact phone number (214) 692-8660.

The enumeration date for this NPI number is 1/8/2008 and was last updated on 5/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		E6315	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00257W	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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