Glenn Abe Mcdonald (NPI# 1336104389, PAC ID# 9638126204) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1336104389 |
| PAC ID by PECOS | 9638126204 |
| Professional Enrollment ID | I20050405001423 |
| Full Name | Glenn Abe Mcdonald |
| Organization Legal Name | EAST TEXAS KIDNEY SPECIALISTS,PA |
| Address |
1402 N 4th St Longview TX 75601-4774 |
| Phone Number | 9032349992 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON |
| Graduation Year | 1990 |
| Primary Specialty | NEPHROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 6901856806 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450032 | GOOD SHEPHERD MEDICAL CENTER MARSHALL |
| 450702 | LONGVIEW REGIONAL MEDICAL CENTER |
| 450210 | EAST TEXAS MEDICAL CENTER - CARTHAGE |
| 450475 | ETMC HENDERSON |
| 450080 | TITUS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1402 N 4th St, Longview, TX 75601-4774 | 9032349992 | EAST TEXAS KIDNEY SPECIALISTS,PA |
| Organization Legal Name | EAST TEXAS KIDNEY SPECIALISTS,PA |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rajiv Sb Vij | Nephrology | East Texas Kidney Specialists,pa | 1402 N 4th St, Longview, TX 75601-4774 |
| Snehal Shrivastava | Nephrology | East Texas Kidney Specialists,pa | 1402 N 4th St, Longview, TX 75601-4774 |
| Venkatesh Salguti Reddy | Internal Medicine | East Texas Kidney Specialists,pa | 1402 N 4th St, Longview, TX 75601-4774 |
| Shobha Shakamuri | Nephrology | East Texas Kidney Specialists,pa | 1402 N 4th St, Longview, TX 75601-4774 |
| Street Address |
1402 N 4TH ST |
| City | LONGVIEW |
| State | TX |
| Zip | 75601-4774 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rajiv Sb Vij | Nephrology | East Texas Kidney Specialists,pa | 1402 N 4th St, Longview, TX 75601-4774 |
| Snehal Shrivastava | Nephrology | East Texas Kidney Specialists,pa | 1402 N 4th St, Longview, TX 75601-4774 |
| Venkatesh Salguti Reddy | Internal Medicine | East Texas Kidney Specialists,pa | 1402 N 4th St, Longview, TX 75601-4774 |
| Shobha Shakamuri | Nephrology | East Texas Kidney Specialists,pa | 1402 N 4th St, Longview, TX 75601-4774 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daytral Matasha Brown | Nurse Practitioner | 103 Woodbine Pl A, The Beverly Clinic, Longview, TX 75601-2912 | |
| Andrea M Marjason | Clinical Social Worker | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Michelle Ann Vess | Physician Assistant | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Donald Winsted | Psychologist, Clinical | 103 Woodbine Pl A, Longview, TX 75601-2912 | |
| Courtney Elizabeth Treat | Physician Assistant | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Jeremiah R Sanders | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Carrie D Hinton | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Gracie M Adkisson | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Longview, TX 75601-2912 |
| Debbie L Anderson | Clinical Social Worker | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Thomas Jay Dehaven | Ophthalmology | Trinity Clinic | 1705 Judson Rd, Longview, TX 75601-2938 |
| Find all physicians in zip 75601 | |||
| City | LONGVIEW |
| Zip Code | 75601 |
| Specialty | NEPHROLOGY |
| City + Specialty | LONGVIEW + NEPHROLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.