MEDICARE: O MEARA ROSADO DPM PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier
3	213ES0103X	Foot & Ankle Surgery Podiatrist	1835	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619215365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O MEARA ROSADO DPM PLLC

Provider Business Mailing Address
First Line	:	1397 GEORGE DIETER DR STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7681
Country	:	US
Telephone Number	:	915-503-2020
Fax Number	:	915-996-9574

Provider Business Practice Location Address
First Line	:	1397 GEORGE DIETER DR STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7681
Country	:	US
Telephone Number	:	915-503-2020
Fax Number	:	915-996-9574

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JOSE RAFAEL GONZALEZ MARTINEZ
Credential	:
Telephone Number	:	915-503-2020

Provider Enumeration Date	:	01/30/2013
Last Update Date	:	08/21/2025

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Directions to “O MEARA ROSADO DPM PLLC ” Practice Location

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