| Vincent A Glass Psy D Inc P C | |
|
3201 N Mustang Rd Ste A Yukon OK 73099-3399 | |
| (405) 354-5777 | |
| (405) 324-9512 |
| Full Name | Vincent A Glass Psy D Inc P C |
|---|---|
| Speciality | Psychologist |
| Location | 3201 N Mustang Rd Ste A, Yukon, Oklahoma |
| Authorized Official Name and Position | Vincent Arthur Glass (PRESIDENT) |
| Authorized Official Contact | 4053545777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vincent A Glass Psy D Inc P C 3201 N Mustang Rd Ste A Yukon OK 73099-3399 Ph: (405) 354-5777 | Vincent A Glass Psy D Inc P C 3201 N Mustang Rd Ste A Yukon OK 73099-3399 Ph: (405) 354-5777 |
| NPI Number | 1205035458 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 07/17/2007 |
| Medicare PECOS PAC ID | 1850307745 |
|---|---|
| Medicare Enrollment ID | O20060301000794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205035458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 765 (Oklahoma) | Primary |
| Provider Name | Vincent A Glass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912941535 PECOS PAC ID: 5193611606 Enrollment ID: I20040223000879 |
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