Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | R2939 | TX |
NPI | 1033380480 |
---|---|
Provider Name | Dr. Sherine Alicia Patterson-Rose |
First Address | Houston, TX 77266-6308 |
Second Address | Houston, TX 77099-1331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2008 |
Last Update Date | 06/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R2939 | TEXAS MEDICAL BOARD (01) | TX |