Doctor Name: | L. GLEN WILBERT |
NPI Number: | 1053310359 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | K1320 |
Business Practice Address: | 1845 Precinct Line Rd Ste 209 Hurst, TX - 760543109 |
Business Phone Number: | 8173364638 |
Business Fax Number: | 8173361331 |
Mailing Address: | 1845 Precinct Line Rd Ste 209, HURST |
State: | TX |
Postal Code: | 760543109 |
Phone Number: | 8173364638 |
Fax Number: | 8173361331 |
NPI Enumeration Date: | 07/19/2005 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | K1320 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |