Healthcare Provider Details

I. General information

NPI: 1134456726
Provider Name (Legal Business Name): SARA ROZIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 11/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6218 ROLLINGBROOK DR
HOUSTON TX
77096
US

IV. Provider business mailing address

6218 ROLLINGBROOK DR
HOUSTON TX
77096-5629
US

V. Phone/Fax

Practice location:
  • Phone: 832-452-1592
  • Fax:
Mailing address:
  • Phone: 832-452-1592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number1000341
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: