Individual provider · NPI-1

Glen David Adams, LP, CCP

Perfusionist · Dallas, TX

NPI number1053535757
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1053535757
Entity type
Individual (NPI-1)
Name
Mr. Glen David Adams
Credential
LP, CCP
Sex
Male
Sole proprietor
No
Enumeration date
Apr 12, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
242T00000X PerfusionistPF0046TXYes

Practice location

3409 Worth St
Suite 725
Dallas, TX 75246-2029

Phone 214-824-2510

Mailing address

7317 Wake Forrest Dr
Dallas, TX 75214-1750

Phone 214-503-6144

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