Mr Glen Eldon Tullous Iii, FNP-C in Fort Worth, TX

Mr Glen Eldon Tullous Iii, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Fort Worth, Texas. He graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Ppg Health Pa and his current practice location is 1001 Pennsylvania Ave, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at (817) 877-5858.

Mr Glen Eldon Tullous Iii is licensed to practice in Texas (license number 1023704) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1720652167.

Contact Information

	Mr Glen Eldon Tullous Iii, FNP-C
	1001 Pennsylvania Ave, Fort Worth, TX 76104-2228
	(817) 877-5858
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Glen Eldon Tullous Iii
Gender	Male
Speciality	Nurse Practitioner
Experience	4 Years
Location	1001 Pennsylvania Ave, Fort Worth, Texas
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Glen Eldon Tullous Iii graduated from nursing school in 2020

NPI Data:

NPI Number: 1720652167
Provider Enumeration Date: 05/19/2021
Last Update Date: 09/02/2022

Medicare PECOS Information:

PECOS PAC ID: 8123422839
Enrollment ID: I20210803001386

Medical Identifiers

Medical identifiers for Mr Glen Eldon Tullous Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720652167	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	1023704 (Texas)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Ppg Health Pa	7113904657	31

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Glen Eldon Tullous Iii allows following entities to bill medicare on his behalf.

Entity Name	Ppg Health Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295736973 PECOS PAC ID: 7113904657 Enrollment ID: O20040702000316

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Glen Eldon Tullous Iii is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Glen Eldon Tullous Iii, FNP-C 1000 W Cannon St, Fort Worth, TX 76104-3029 Ph: (817) 725-7900	Mr Glen Eldon Tullous Iii, FNP-C 1001 Pennsylvania Ave, Fort Worth, TX 76104-2228 Ph: (817) 877-5858

Reviews and Comments

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Mr Glen Eldon Tullous Iii, FNP-C - Medicare Nurse Practitioner in Fort Worth, TX