SHANNON B. GLASS (NPI# 1982923975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982923975 |
| Entity Type | Individual |
| Full Name | SHANNON B. GLASS |
| Credential | MD |
| Practice Address |
11937 Us Highway 271 Tyler TX 75708 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-1656 |
| Practice Telephone | 9038777777 |
| Mailing Telephone | 9035315000 |
| Enumeration Date | 2010-05-31 |
| Last Update Date | 2018-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Q1611 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8JW906 | 01 |
| TX | MEDICARE RAIL ROAD | P02057870 | 01 |
| TX | BCBS | 8JP975 | 01 |
| TX | 348611003 | 05 | |
| TX | MEDICARE | 667934 | 01 |
| TX | 348611004 | 05 | |
| TX | MEDICARE | 667447 | 01 |
| TX | MEDICARE RAIL ROAD | P02057868 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11937 Us Highway 271, Tyler, TX 757083154 | 9038777777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316383342 | Shannon M Glass | Counselor | 15 Declaration Dr, Chico, CA 95973-4902 | 2013-05-16 |
| Street Address |
11937 US HIGHWAY 271 |
| City | TYLER |
| State | TX |
| Zip Code | 75708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245233550 | Frances L. Elizondo | Physician Assistant | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2005-05-31 |
| 1497355481 | Jessie Ann Gibson | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-28 |
| 1538767397 | Ian Joseph Gomez | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-14 |
| 1588262562 | Jamie R Antwine | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-13 |
| 1679171797 | Christian Paul Fant | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-12 |
| 1912512468 | Halle Ross-young | Psychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-09-11 |
| 1093328700 | Joshua Morgan | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-08-24 |
| 1811509011 | Kavya Parasa | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-08-19 |
| 1326657792 | Pelin D Strebler | Clinical Neuropsychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-07-30 |
| 1508483082 | Chi Nguyen Benson | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427615699 | Aiat Radwan | Student in an Organized Health Care Education/Training Program | 11937 U Highway 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-23 |
| 1174170781 | Sanmitha Sundaram Kota | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-08-20 |
| 1952960437 | Parashar Trivedi | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-06-10 |
| 1659937506 | Sandhya Devaraj | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-16 |
| 1972169381 | Mary Kaar | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1396301701 | Joshua Penrod | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1558927962 | Ijeoma Nwaigwe | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1487210894 | David Pollard | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1477119873 | Aparna Kanuparthy | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1275199689 | Prithvi Muddana | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| Find all providers in zip 75708 | ||||
| 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 |
|---|---|---|---|---|
| 1518220367 | Beurett Alexander King Jr. | Radiology | 1517 Cold Water Dr, Tyler, TX 75703-0937 | 2012-06-18 |
| 1093039539 | Melinda Faye Coker | Radiology | 910 E Houston St Ste 650, Tyler, TX 75702 | 2010-03-25 |
| 1548219025 | Sonowave Inc. | Radiology | 417 S Chilton Ave, Tyler, TX 75702-8017 | 2006-05-10 |
| 1427019447 | Ralph A Gutierrez | Radiology | 1021 E Watkins St, Tyler, TX 75701-7120 | 2006-03-29 |
| 1164495974 | Joe Buck Caldwell | Radiology | 520 East Douglas Blvd, Tyler, TX 75702 | 2006-02-10 |
| 1477554673 | James F. Cabell IIi | Radiology | 627 Turtle Creek Dr, Tyler, TX 75701-1832 | 2005-08-10 |
| 1871594697 | Modified Barium Swallow Service, P.a. | Radiology | 3724 Fm 346 E, Tyler, TX 75703-8340 | 2005-08-02 |
| 1962814798 | Justin Mccaslin | Radiology | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2014-05-28 |
| 1689963357 | Jose Luis Enriquez | Radiology | 627 Turtle Creek Dr, Tyler, TX 75701-1832 | 2011-04-04 |
| 1578879151 | Blake A Watson | Radiology | 627 Turtle Creek Dr, Tyler, TX 75701-1832 | 2010-08-20 |
| Find all providers in TYLER | ||||
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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.