Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 0025523 | TX |
Y | 213EG0000X | General Practice | 0025523 | TX |
NPI | 1003136797 |
---|---|
Provider Name | Alex Rouse |
First Address | Houston, TX 77084-6527 |
Second Address | Houston, TX 77049-2524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2010 |
Last Update Date | 04/06/2010 |