Provider Demographics
NPI:1720384498
Name:GLOSTER MORRIS, DANIELLE R (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:R
Last Name:GLOSTER MORRIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 E PLEASANT RUN RD STE A
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4200
Mailing Address - Country:US
Mailing Address - Phone:972-223-2020
Mailing Address - Fax:972-223-1860
Practice Address - Street 1:1233 E PLEASANT RUN RD STE A
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4200
Practice Address - Country:US
Practice Address - Phone:972-223-2020
Practice Address - Fax:972-228-1860
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7670TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX220236801Medicaid