Provider Demographics
NPI:1437679693
Name:GLENN, DANIELLE LEIGH
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LEIGH
Last Name:GLENN
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 1:4141 SOUTHWEST FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7330
Mailing Address - Country:US
Mailing Address - Phone:713-223-1800
Mailing Address - Fax:
Practice Address - Street 1:4141 SOUTHWEST FWY STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7330
Practice Address - Country:US
Practice Address - Phone:713-223-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1249649225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist