Provider Demographics
NPI:1164430997
Name:TURNER, DAVID GLENN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GLENN
Last Name:TURNER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:149 S. US HWY 59
Mailing Address - City:GARRISON
Mailing Address - State:TX
Mailing Address - Zip Code:75946-0297
Mailing Address - Country:US
Mailing Address - Phone:936-347-3322
Mailing Address - Fax:936-347-3325
Practice Address - Street 1:149 SOUTH U.S. HWY 59
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:TX
Practice Address - Zip Code:75946
Practice Address - Country:US
Practice Address - Phone:936-347-3322
Practice Address - Fax:936-347-3325
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1154304467OtherMEDICAL DIRECTOR'S
PA01924OtherPA
TX158535801Medicaid
TX158535801Medicaid