L. GLEN WILBERT III (NPI# 1053310359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053310359 |
| Entity Type | Individual |
| Full Name | L. GLEN WILBERT III |
| Credential | MD |
| Practice Address |
1845 Precinct Line Rd Ste 209 Hurst TX 76054-3109 |
| Practice Telephone | 8173364638 |
| Practice Fax Number | 8173361331 |
| Mailing Telephone | 8173364638 |
| Mailing Fax Number | 8173361331 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2016-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
K1320 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE RR | 300097656 | 01 |
| TX | 124692803 | 05 |
| Street Address |
1845 PRECINCT LINE RD STE 209 |
| City | HURST |
| State | TX |
| Zip Code | 76054-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730490467 | Jeffry Alan Brace | Radiology | 1845 Precinct Line Rd Ste 209, Hurst, TX 76054-3109 | 2010-06-28 |
| 1518286640 | Victor Longo IIi | Radiology | 1845 Precinct Line Rd Ste 209, Hurst, TX 76054 | 2010-05-28 |
| 1043463318 | Nidhi Kacholiya | Radiology | 1845 Precinct Line Rd Ste 209, Second Floor, Hurst, TX 76054-3109 | 2008-10-30 |
| 1760686349 | Sangeeta Neela | Radiology | 1845 Precinct Line Rd Ste 209, Apt# 207, Hurst, TX 76054-3109 | 2007-06-14 |
| 1457555435 | Christopher Brian Messier | Radiology | 1845 Precinct Line Rd Ste 209, Second Floor, Hurst, TX 76054-3109 | 2007-06-13 |
| 1780888750 | Sivan S Golan | Radiology | 1845 Precinct Line Rd Ste 209, Hurst, TX 76054 | 2007-06-13 |
| 1245374537 | Jeffrey K Leitko | Radiology | 1845 Precinct Line Rd Ste 209, Second Floor, Hurst, TX 76054-3109 | 2007-02-19 |
| 1225189392 | Padmavathi N Srinivasan | Radiology | 1845 Precinct Line Rd Ste 209, Hurst, TX 76054-3109 | 2007-01-16 |
| 1659318038 | Raghuram M Reddy | Radiology | 1845 Precinct Line Rd Ste 209, Hurst, TX 76054-3109 | 2006-06-02 |
| 1255312740 | Larry Keith Jordan | Radiology | 1845 Precinct Line Rd Ste 209, Second Floor, Hurst, TX 76054-3109 | 2005-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942856224 | Nancy Lopez | Speech-Language Pathologist | 6168 Bentridge Rd, Hurst, TX 76054 | 2019-08-13 |
| 1942771134 | James L Thomason Md | Psychiatry & Neurology | 769 Lonesome Dove Trail, Hurst, TX 76054 | 2018-12-16 |
| 1114498672 | Alpha Hyperbarics Pllc | Preventive Medicine | 1845 Precinct Line Road, Ste 105, Hurst, TX 76054 | 2018-12-10 |
| 1922555234 | U S Anesthesia Partners of Texas, Pa | Anesthesiology | 809 W Harwood Rd Ste 103, Hurst, TX 76054 | 2016-09-02 |
| 1427422765 | Stephen Craig Sims | Dentist | 1725 Cimarron Trail, Suite 1, Hurst, TX 76054 | 2015-11-24 |
| 1629464342 | Meredith Drake | Pediatrics | 731 Martin Road, Hurst, TX 76054 | 2015-04-09 |
| 1104236454 | Jessica Shepard,ma,lpc | Counselor | 1817 Harwood Court, Hurst, TX 76054 | 2014-05-07 |
| 1801225016 | Hearing Essentials of Texas, Inc. | Clinic/Center | 672 Grapevine Hwy, Hurst, TX 76054 | 2013-11-07 |
| 1265787337 | Sarah Michele Talbott | Optometrist | 2817 Hurstview Dr., Hurst, TX 76054 | 2012-07-16 |
| 1174801617 | Robert Harry Levy | Dentist | 828 Harwood Rd, Tarrant County College Dental Hygiene Program, Hurst, TX 76054 | 2011-08-02 |
| Find all providers in zip 76054 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922034602 | Consultants In Radiology, Pa | Radiology | 1845 Precinct Line Rd, Ste. 209, Hurst, TX 76054-3179 | 2006-06-24 |
| 1306183702 | Tanja Minova Foster | Radiology | 1845 Precinct Line Rd, Ste 209, Hurst, TX 76054-3109 | 2013-01-07 |
| 1518286640 | Victor Longo IIi | Radiology | 1845 Precinct Line Rd Ste 209, Hurst, TX 76054 | 2010-05-28 |
| 1043463318 | Nidhi Kacholiya | Radiology | 1845 Precinct Line Rd Ste 209, Second Floor, Hurst, TX 76054-3109 | 2008-10-30 |
| 1760686349 | Sangeeta Neela | Radiology | 1845 Precinct Line Rd Ste 209, Apt# 207, Hurst, TX 76054-3109 | 2007-06-14 |
| 1457555435 | Christopher Brian Messier | Radiology | 1845 Precinct Line Rd Ste 209, Second Floor, Hurst, TX 76054-3109 | 2007-06-13 |
| 1780888750 | Sivan S Golan | Radiology | 1845 Precinct Line Rd Ste 209, Hurst, TX 76054 | 2007-06-13 |
| 1972724086 | Narayana Swamy Mamillapalli | Radiology | 1845 Precinct Line Rd, Suite 209, Hurst, TX 76054 | 2007-05-02 |
| 1245374537 | Jeffrey K Leitko | Radiology | 1845 Precinct Line Rd Ste 209, Second Floor, Hurst, TX 76054-3109 | 2007-02-19 |
| 1659318038 | Raghuram M Reddy | Radiology | 1845 Precinct Line Rd Ste 209, Hurst, TX 76054-3109 | 2006-06-02 |
| Find all providers in HURST | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.