Provider Demographics
NPI:1508052036
Name:GLASS, DONALD ALEXANDER II (MD, PH,D,)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ALEXANDER
Last Name:GLASS
Suffix:II
Gender:M
Credentials:MD, PH,D,
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Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:ROOM JA5.120, MAIL CODE 9069
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9069
Mailing Address - Country:US
Mailing Address - Phone:214-648-2703
Mailing Address - Fax:214-648-9292
Practice Address - Street 1:5939 HARRY HINES BLVD
Practice Address - Street 2:POB-2, 4TH FLOOR, SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390
Practice Address - Country:US
Practice Address - Phone:214-645-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2011-08-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN9211207N00000X
PAMD438676207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology