Provider Demographics
NPI:1487809067
Name:GLENN L. MORGAN M.D.,PA
Entity type:Organization
Organization Name:GLENN L. MORGAN M.D.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LVN, INSURANCE PROCESSOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-444-0865
Mailing Address - Street 1:17070 RED OAK DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2616
Mailing Address - Country:US
Mailing Address - Phone:281-444-0865
Mailing Address - Fax:281-444-6037
Practice Address - Street 1:17070 RED OAK DRIVE, STE 301
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090
Practice Address - Country:US
Practice Address - Phone:281-444-0865
Practice Address - Fax:281-444-6037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0606207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL913214700Medicaid
TX0096DNOtherBLUE CROSS BLUE SHIELD
LA1381748Medicaid
TX160056100OtherRAIL ROAD
TX111898602Medicaid
TXB65629OtherUPIN
TX111898602Medicaid
TX00150JMedicare PIN