Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | N0712 | TX |
NPI | 1023384005 |
---|---|
Provider Name | Dr. Rosella Diaz Creed |
First Address | Pearland, TX 77584-7298 |
Second Address | Richmond, TX 77407-2140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2012 |
Last Update Date | 07/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
357260401 | (05) | TX |
357260402 | (05) | TX |