Healthcare Provider Details

I. General information

NPI: 1508350687
Provider Name (Legal Business Name): RACHEL ALEXANDRIA ROSARIO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6902 SOUTHWEST FWY
HOUSTON TX
77074-2106
US

IV. Provider business mailing address

5800 N I 35 STE 205
DENTON TX
76207-1438
US

V. Phone/Fax

Practice location:
  • Phone: 281-656-1011
  • Fax:
Mailing address:
  • Phone: 940-220-7833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11116
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number40419
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: