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Mr. Mark William Glass
Surgical Physician Assistant in Addison, Texas
NPI 1013021161

Mark William Glass is a Surgical Physician Assistant based in Dallas, TX and is specialized in Surgical. Mark William Glass practices in Addison, TX. The NPI Number for Mark William Glass is 1013021161 and holds a License No. PA02857 (Texas).

The current practice location address for Mark William Glass is 17051 Dallas Pkwy Ste 400, Addison, TX and can be reached out via phone at 214-370-3535 and via fax at 214-370-0004.

Location: 17051 Dallas Pkwy Ste 400, Addison, TX, 75206-9114
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013021161
Provider Name
Mark William Glass
Credential
Provider Entity Type
Individual
Gender
Male
Address
17051 Dallas Pkwy Ste 400, Addison, TX, 75206-9114
Phone Number
214-370-3535
Fax Number
214-370-0004
Provider Enumeration Date
08/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
209276607 05 TX
806N48 01 TX BLUE CROSS/BLUE PIN
institution
Provider Business Practice Location Address Details
Address
17051 Dallas Pkwy Ste 400
City
Addison
State
Texas
Zip
75001-7108
Phone Number
214-370-3535
Fax Number
214-370-0004
person
Provider Business Mailing Address Details
Address
17051 Dallas Pkwy Ste 400
City
Addison
State
Texas
Zip
75001-7108
Phone Number
214-370-3535
Fax Number
214-370-0004
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
PA02857 (Texas)
Definition
Definition to come...
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