Provider Demographics
NPI:1861713828
Name:ROBERT B GLEDHILL,M.D.,P.A.
Entity type:Organization
Organization Name:ROBERT B GLEDHILL,M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:GLEDHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-615-8292
Mailing Address - Street 1:7220 LOUIS PASTEUR DR STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4534
Mailing Address - Country:US
Mailing Address - Phone:210-615-8292
Mailing Address - Fax:210-615-8297
Practice Address - Street 1:7220 LOUIS PASTEUR DR STE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4534
Practice Address - Country:US
Practice Address - Phone:210-615-8292
Practice Address - Fax:210-615-8297
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT B GLEDHILL, M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-14
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4820207XS0117X, 207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200041186OtherRAILROAD MEDICARE
TX294505701Medicaid
TX1133936-03Medicaid
TX1133936-03Medicaid