Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1570 | TX |
Y | 222Z00000X | Podiatrist | 1570 | TX |
N | 224P00000X | Prosthetist | 1570 | TX |
NPI | 1295172021 |
---|---|
Provider Name | Mrs. Amelia Sue Rosetta-Warren |
First Address | Houston, TX 77004-4046 |
Second Address | Houston, TX 77004-4046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2013 |
Last Update Date | 25/07/2016 |