Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | L7539 | TX |
NPI | 1184678021 |
---|---|
Provider Name | Alex Rosin |
First Address | San Antonio, TX 78248-2100 |
Second Address | Seguin, TX 78155-5129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 18/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
162970104 | (05) | TX |
162970110 | (05) | TX |
16297016 | (05) | TX |
H97743 | (02) | TX |