Provider Demographics
NPI:1578590535
Name:GLAZER, BRIAN JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAY
Last Name:GLAZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:110 E SAVANNAH AVE
Mailing Address - Street 2:BLDG B SUITE 202
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1241
Mailing Address - Country:US
Mailing Address - Phone:956-686-7611
Mailing Address - Fax:956-618-3164
Practice Address - Street 1:110 E SAVANNAH AVE
Practice Address - Street 2:BLDG B SUITE 202
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1241
Practice Address - Country:US
Practice Address - Phone:956-686-7611
Practice Address - Fax:956-618-3164
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH3055207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032815501Medicaid
TX110020562OtherTX RAILROAD MEDICARE
TX110020562OtherTX RAILROAD MEDICARE
TX00DR18Medicare PIN