Provider Demographics
NPI:1932864212
Name:ALFORD, GLENDA GAIL
Entity type:Individual
Prefix:MS
First Name:GLENDA
Middle Name:GAIL
Last Name:ALFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4516 LEMON RD
Mailing Address - Street 2:
Mailing Address - City:BIG SANDY
Mailing Address - State:TX
Mailing Address - Zip Code:75755-5330
Mailing Address - Country:US
Mailing Address - Phone:903-841-2206
Mailing Address - Fax:
Practice Address - Street 1:4516 LEMON RD
Practice Address - Street 2:
Practice Address - City:BIG SANDY
Practice Address - State:TX
Practice Address - Zip Code:75755-5330
Practice Address - Country:US
Practice Address - Phone:903-841-2206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130555164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse