Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 34176 | TX |
Y | 213EG0000X | General Practice | 34176 | TX |
NPI | 1003301730 |
---|---|
Provider Name | Dr. Nan Mae Rosas |
First Address | Pearland, TX 77584-4161 |
Second Address | Pearland, TX 77584-4161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2018 |
Last Update Date | 25/06/2018 |