MR. GLENN PETERSON (NPI# 1295083699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295083699 |
| Entity Type | Individual |
| Full Name | MR. GLENN PETERSON |
| Credential | PTA |
| Practice Address |
871 Old Alice Rd Suite 600 Brownsville TX 78520-8268 |
| Practice Telephone | 6157148177 |
| Mailing Telephone | 6157148177 |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2013-07-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | 2088488 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | STATE LICENSE NUMBER | 2088488 | 01 |
| TX | STATE LICENCE NUMBER | 2088488 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427026913 | Glenn R Peterson | Psychiatry & Neurology | 9301 Parkwest Boulevard, Knoxville, TN 37923 | 2006-03-09 |
| 1972031698 | Glenn Adam Peterson | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2017-05-25 |
| 1629314729 | Glenn A Peterson | Counselor | 5870 Arlington Ave, # 103, Riverside, CA 92504-2037 | 2012-12-17 |
| Street Address |
871 OLD ALICE RD SUITE 600 |
| City | BROWNSVILLE |
| State | TX |
| Zip Code | 78520-8268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194819094 | Madalena Mendoza-gonzales | Speech-Language Pathologist | 871 Old Alice Rd, Suite 600, Brownsville, TX 78520-8268 | 2006-10-03 |
| 1992272140 | Gabriel Claudio | Occupational Therapy Assistant | 871 Old Alice Rd, Brownsville, TX 78520-8268 | 2018-10-25 |
| 1104303825 | Denisse Elizondo | Specialist/Technologist | 871 Old Alice Rd, Brownsville, TX 78520-8268 | 2018-07-25 |
| 1568998581 | Gladys Quidlat | Physical Therapy Assistant | 871 Old Alice Rd, Suite 600, Brownsville, TX 78520-8268 | 2017-05-11 |
| 1144754383 | Caitlin Yauch | Physical Therapy Assistant | 871 Old Alice Rd, Suite 600, Brownsville, TX 78520-8268 | 2017-04-14 |
| 1588106314 | Adriana Pequeno | Specialist/Technologist | 871 Old Alice Rd, Suite 600, Brownsville, TX 78520-8268 | 2016-11-10 |
| 1700335353 | Monica Reyna | Specialist/Technologist | 871 Old Alice Rd, Suite 600, Brownsville, TX 78520-8268 | 2016-09-23 |
| 1619426277 | Ruth Juarez | Speech-Language Pathologist | 871 Old Alice Rd, Suite 600, Brownsville, TX 78520-8268 | 2016-09-23 |
| 1376090274 | Taylor Hohbach | Physical Therapy Assistant | 871 Old Alice Rd, Brownsville, TX 78520-8268 | 2016-09-08 |
| 1457805947 | Daniela Saenz | Speech-Language Pathologist | 871 Old Alice Rd, Suite 600, Brownsville, TX 78520-8268 | 2016-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861090243 | Ridgewood Psychiatry Pllc | Psychiatry & Neurology | 832 Ridgewood St, Brownsville, TX 78520 | 2020-10-16 |
| 1144850520 | Hellen Rurangirwa Md Pa Pediatric Clinic | Pediatrics | 2648 W Alton Gloor, Brownsville, TX 78520 | 2020-01-24 |
| 1235698911 | South Texas Neurosurgery Associates | Neurological Surgery | 3475 W Alton Gloor Blvd Ste A, Brownsville, TX 78520 | 2019-03-13 |
| 1952884520 | Bianca Gonzalez | Physical Therapy Assistant | 4834 Beaver Pond Dr., Brownsville, TX 78520 | 2018-09-10 |
| 1871087775 | Ariana Quiroga | Durable Medical Equipment & Medical Supplies | 2776 W Alton Gloor Blvd Ste 3, Brownsville, TX 78520 | 2018-06-14 |
| 1134622863 | Ebony Center Pllc | Counselor | 2905 Central Blvd., Suite C, Brownsville, TX 78520 | 2018-03-08 |
| 1770083560 | Maria D Gaona | Registered Nurse | 2666 Laredo Rd, Brownsville, TX 78520 | 2018-02-18 |
| 1710496419 | T & B Espino Inc | Technician | 2226 Athens St, Brownsville, TX 78520 | 2017-09-25 |
| 1558891150 | Horizon Primary Home Care,inc | In Home Supportive Care | 556 W. Elizabeth St. Ste A, Brownsville, TX 78520 | 2017-06-15 |
| 1306377148 | Jessica Gutierrez | Nurse Practitioner | 2404 El Gusto St, Brownsville, TX 78520 | 2017-03-23 |
| Find all providers in zip 78520 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518575869 | Angels United Home Care LLC | Developmental Therapist | 2417 Anton Dr, Forney, TX 75126-2440 | 2020-07-22 |
| 1497398952 | Corina Josette Ryba | Developmental Therapist | 24124 Cinco Village Center Blvd Ste 200, Katy, TX 77494-8389 | 2019-10-28 |
| 1104345321 | Lee M Fisher | Developmental Therapist | 10333 Mosscrest Dr, Dallas, TX 75238 | 2017-09-19 |
| 1376074831 | Johnny Lewis | Developmental Therapist | 4228 Boxwood Dr, Balch Springs, TX 75180-3626 | 2017-03-24 |
| 1316497324 | Matthew Gibbs | Developmental Therapist | 2110 E State Highway 36, Abilene, TX 79602-6504 | 2016-10-13 |
| 1245787050 | Elanore Walsh | Developmental Therapist | 3974 Wilshire Dr, Abilene, TX 79603-4113 | 2016-09-09 |
| 1548717200 | Jordan Purifoy | Developmental Therapist | 759 E North 13th St, Abilene, TX 79601-3830 | 2016-09-09 |
| 1962959841 | Simone Deloach | Developmental Therapist | 5125 Fairmont St Apt 1422, Abilene, TX 79605-3583 | 2016-09-08 |
| 1033666250 | Jean Dotson | Developmental Therapist | 47 Hoylake Dr, Abilene, TX 79606-5127 | 2016-09-06 |
| 1144776378 | Johanna Rojas Hidalgo | Developmental Therapist | 100 Congress Avenue, Suite 2000, Austin, TX 78701 | 2016-08-28 |
| Find all providers with the same taxonomy | ||||
| City | BROWNSVILLE |
| Zip Code | 78520 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.