Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | M8677 | TX |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | M8677 | TX |
NPI | 1679785448 |
---|---|
Provider Name | Craig Russell Glauser |
First Address | San Antonio, TX 78205-2534 |
Second Address | San Antonio, TX 78205-2544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
197321603 | (05) | TX |