Provider Demographics
NPI:1356322465
Name:FEINSTEIN, GLEN IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:GLEN
Middle Name:IRA
Last Name:FEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1139 E SONTERRA BLVD
Mailing Address - Street 2:STE 260
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4347
Mailing Address - Country:US
Mailing Address - Phone:210-404-2800
Mailing Address - Fax:210-404-2803
Practice Address - Street 1:1139 E SONTERRA BLVD
Practice Address - Street 2:STE 260
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4347
Practice Address - Country:US
Practice Address - Phone:210-404-2800
Practice Address - Fax:210-404-2803
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK0294207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG84921Medicare UPIN