Glen D Houston
Oral and Maxillofacial Pathology
2701 Coltrane Pl Ste 3
Edmond
, Oklahoma 73034-6783
Glen D Houston
Oral and Maxillofacial Pathology
2701 Coltrane Pl Ste 3
Edmond
, Oklahoma 73034-6783
(405) 715-4500
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Glen D Houston
- 2701 Coltrane Pl Ste 3
- Edmond, OK
- Zip : 73034-6783
- Phone : (405) 715-4500
Second Address
- Glen D Houston
- 2701 Coltrane Pl Ste 3
- Edmond, OK
- Zip : 73034-6783
- Phone : (405) 715-4500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 3753 | OK |
National Provider Identifier
| NPI | 1508835414 |
|---|---|
| Provider Name | Glen D Houston |
| First Address | Edmond, OK 73034-6783 |
| Second Address | Edmond, OK 73034-6783 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/03/2006 |
| Last Update Date | 09/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 800522089 | GROUP MEDICARE (01) | OK |
| U66824 | (02) | OK |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.