Provider Demographics
NPI:1003271495
Name:JOSEPH, GLORY M (PA-C)
Entity Type:Individual
Prefix:
First Name:GLORY
Middle Name:M
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1140 BUSINESS CENTER DR STE 202
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2741
Mailing Address - Country:US
Mailing Address - Phone:713-800-0660
Mailing Address - Fax:713-827-1380
Practice Address - Street 1:10405 KATY FWY STE 150E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1165
Practice Address - Country:US
Practice Address - Phone:713-722-9660
Practice Address - Fax:713-722-9664
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2023-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA12387363A00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant