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MR. GLEN ELDON TULLOUS III FNP-C
NPI 1720652167
Nurse Practitioner - Family in Fort Worth, TX

Active since May 19, 2021PECOS EnrolledAccepts Medicare Assignment
1001 12TH AVE STE 102, FORT WORTH, TX 76104(817) 725-7880 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2025, Sep 2, 2022, May 19, 2021 (3 updates tracked since 2021).

About Mr. Glen Eldon Tullous Iii Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GLEN ELDON TULLOUS III FNP-C (NPI 1720652167) is an individual family provider in Fort Worth, Texas, licensed in Texas (1023704) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Texas Health Huguley Hospital Fort Worth South, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1720652167
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. GLEN ELDON TULLOUS IIICredential: FNP-C
Location Address1001 12TH AVE STE 102Fort Worth, TX 76104-3926
Mailing Address1000 W Cannon StFort Worth, TX 76104-3029 · (817) 725-7900
Phone(817) 725-7880
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 19, 2021
Last NPPES UpdateApril 2, 20253 updates tracked since enumeration
NPPES CertifiedApril 2, 2025
✔ NPI 1720652167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · 1023704
1001 12TH AVE STE 102, Fort Worth, TX 76104
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Imperial Insurance Companies, Inc., Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Glen Eldon Tullous Iii Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123422839
PECOS Enrollment IDI20210803001386
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
46 services36 patients
Face-to-face behavioral counseling for obesity, 15 minutes G0447
This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.
18 services17 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Texas Health Huguley Hospital Fort Worth South

Acute Care Hospitals · Burleson, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450677
Location11801 South FreewayBurleson, TX 76028 · Johnson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH DREHER
Physician Assistant
1001 12TH AVE STE 102
FORT WORTH, TX 76104
Tarrant County (817) 725-7880
FEEZA HASAN
Internal Medicine
1001 12TH AVE STE 102
FORT WORTH, TX 76104
Tarrant County (817) 725-7880
DR. MANITH BONDUGULA
Internal Medicine
1001 12TH AVE STE 102
FORT WORTH, TX 76104
Tarrant County (817) 725-7880
MS. CAROL ELIZABETH LEIDLEIN APRN
Nurse Practitioner
1001 12TH AVE STE 102
FORT WORTH, TX 76104
Tarrant County (817) 877-4105

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Tullous's NPI number?

The NPI number for Glen Tullous is 1720652167. It was assigned to this individual provider in the NPPES registry on May 19, 2021.

Where is Glen Tullous located?

Glen Tullous practices at 1001 12th Ave Ste 102, Fort Worth, TX 76104. The listed phone number is (817) 725-7880.

What is Glen Tullous's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Glen Tullous enrolled in Medicare?

Yes. Glen Tullous is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Glen Tullous accept?

Health plans from Blue Cross and Blue Shield of Texas, Imperial Insurance Companies, Inc., Oscar Insurance Company, UnitedHealthcare and WellPoint list Glen Tullous as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Glen Tullous affiliated with any hospitals?

According to CMS data, Glen Tullous is affiliated with Texas Health Huguley Hospital Fort Worth South.

When was this NPI record last updated?

The NPPES record for Glen Tullous was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.