Provider Demographics
NPI:1891953782
Name:JEFFREY M ADELGLASS MD AND ASSOCIATES PA
Entity Type:Organization
Organization Name:JEFFREY M ADELGLASS MD AND ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ADELGLASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-492-6990
Mailing Address - Street 1:6020 W PARKER RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8171
Mailing Address - Country:US
Mailing Address - Phone:972-492-6990
Mailing Address - Fax:972-394-4405
Practice Address - Street 1:6020 W PARKER RD
Practice Address - Street 2:SUITE 400
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8171
Practice Address - Country:US
Practice Address - Phone:972-492-6990
Practice Address - Fax:972-394-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88X481Medicare PIN