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Contact Information

SHANNON B GLASS, MD
11937 US HIGHWAY 271
TYLER, TX75708
 Phone: 903-877-7777
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for SHANNON B GLASS · (Female)

NPI Number 1982923975
Status Active
Credentials MD
Entity Individual
Enumeration date 05/31/2010
Last updated 08/28/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • TX License # Q1611
  • TX Medicaid 348611003
  • TX Medicaid 348611004
  • TX Other 8JP975 BCBS
  • TX Other 8JW906 BCBS
  • TX Other 667447 MEDICARE
  • TX Other 667934 MEDICARE
  • TX Other P02057868 MEDICARE RAIL ROAD
  • TX Other P02057870 MEDICARE RAIL ROAD
Hospital affiliation(s)
  • MOTHER FRANCES HOSPITAL - (Acute Care)
    800 EAST DAWSON
    TYLER, TX 75701
  • MOTHER FRANCES HOSPITAL JACKSONVILLE - (Critical Access)
    2026 S JACKSON STREET
    JACKSONVILLE, TX 75766
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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