Provider Demographics
NPI:1154555126
Name:GLEBUS, GEOFFREY PAUL (DO)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:PAUL
Last Name:GLEBUS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SPURS LN STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1679
Mailing Address - Country:US
Mailing Address - Phone:210-699-8326
Mailing Address - Fax:210-561-7121
Practice Address - Street 1:21 SPURS LN STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240
Practice Address - Country:US
Practice Address - Phone:210-699-8326
Practice Address - Fax:210-561-7121
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003799A207X00000X
TXR5728207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery