Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | J4820 | TX |
N | 207XS0117X | Orthopaedic Spine Surgeon | J4820 | TX |
NPI | 1437267176 |
---|---|
Provider Name | Robert B Gledhill |
First Address | San Antonio, TX 78229-3357 |
Second Address | San Antonio, TX 78229-3357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 06/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113393603 | (05) | TX |