Provider Demographics
NPI:1538157821
Name:STEINKE, GLENNA HALL (DO)
Entity type:Individual
Prefix:MS
First Name:GLENNA
Middle Name:HALL
Last Name:STEINKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:GLENNA
Other - Middle Name:MARIE
Other - Last Name:STEINKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:917-232-5674
Mailing Address - Fax:
Practice Address - Street 1:1860 S SEGUIN AVE BLDG E
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3914
Practice Address - Country:US
Practice Address - Phone:830-626-7770
Practice Address - Fax:855-347-6311
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
115201Medicare ID - Type Unspecified
F87106Medicare UPIN
NY11J201Medicare PIN