Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 10436 | TX |
NPI | 1407938392 |
---|---|
Provider Name | Dr. Jared Charles Rosenberg |
First Address | Webster, TX 77598-4242 |
Second Address | Webster, TX 77598-4242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 10/12/2008 |