Provider Demographics
NPI:1518977636
Name:GLOVER, BRENDA JOYCE
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JOYCE
Last Name:GLOVER
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 1:2501 WESTRIDGE ST
Mailing Address - Street 2:APT # 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1555
Mailing Address - Country:US
Mailing Address - Phone:713-666-8987
Mailing Address - Fax:
Practice Address - Street 1:2501 WESTRIDGE ST
Practice Address - Street 2:APT # 104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1555
Practice Address - Country:US
Practice Address - Phone:713-666-8987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87166164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse