Healthcare Provider Details

I. General information

NPI: 1841353786
Provider Name (Legal Business Name): PAULA JEAN ROSSI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 10/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 MAIN ST SUITE 5200
DALLAS TX
75201-4612
US

IV. Provider business mailing address

10129 CHAPEL SPRINGS TRL
FORT WORTH TX
76116-1252
US

V. Phone/Fax

Practice location:
  • Phone: 800-362-2731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberM4491
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: