| Mr Mark William Glass, | |
|
17051 Dallas Pkwy Ste 400, Addison, TX 75001-7108 | |
| (214) 370-3535 | |
| (214) 370-0004 |
| Full Name | Mr Mark William Glass |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 26 Years |
| Location | 17051 Dallas Pkwy Ste 400, Addison, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013021161 | NPI | - | NPPES |
| 209276607 | Medicaid | TX | |
| 806N48 | Other | TX | BLUE CROSS/BLUE PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | PA02857 (Texas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ortholonestar Pllc | 9931529062 | 416 |
| Entity Name | Ortholonestar PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942860176 PECOS PAC ID: 9931529062 Enrollment ID: O20201012001450 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Mark William Glass, 5927 E University Blvd Apt 221, Dallas, TX 75206-9114 Ph: (214) 926-7117 | Mr Mark William Glass, 17051 Dallas Pkwy Ste 400, Addison, TX 75001-7108 Ph: (214) 370-3535 |
Mr. Ivan Miranda, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 16479 Dallas Pkwy Ste 320, Addison, TX 75001 Phone: 469-484-4260 |
Ms. Carla Michele Harris, MSSC PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 5080 Spectrum Dr, Suite 1200 West Tower, Addison, TX 75001 Phone: 972-720-7848 |
Michael G Omotola, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4135 Belt Line Rd Ste 124, Addison, TX 75001 Phone: 469-495-9126 Fax: 469-495-0726 |
Hannah Duong, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 16901 Dallas Pkwy Ste 208, Addison, TX 75001 Phone: 972-248-2020 |
Alexis Danshelle Pegues, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5040 Addison Cir Ste 400, Addison, TX 75001 Phone: 214-983-0303 |
Melissa Ann Johnston, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 17051 Dallas Pkwy Ste 400, Addison, TX 75001 Phone: 214-370-3535 Fax: 214-370-0004 |
Tiffany C. Hartman, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 16633 Dallas Pkwy Ste 150, Addison, TX 75001 Phone: 972-380-0030 |