Provider Demographics
NPI:1043440688
Name:GLEN E. MCCLURE, PH.D., P.A.
Entity Type:Organization
Organization Name:GLEN E. MCCLURE, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-494-6800
Mailing Address - Street 1:1600 HIGHWAY 6
Mailing Address - Street 2:SUITE 440
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4923
Mailing Address - Country:US
Mailing Address - Phone:281-494-6800
Mailing Address - Fax:281-494-8723
Practice Address - Street 1:1600 HIGHWAY 6
Practice Address - Street 2:SUITE 440
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4923
Practice Address - Country:US
Practice Address - Phone:281-494-6800
Practice Address - Fax:281-494-8723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31228103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty