Healthcare Provider Details

I. General information

NPI: 1508063942
Provider Name (Legal Business Name): SCOTT B ROSENFELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 FANNIN ST
HOUSTON TX
77030-2316
US

IV. Provider business mailing address

2 E GREENWAY PLZ SUITE 900
HOUSTON TX
77046-0297
US

V. Phone/Fax

Practice location:
  • Phone: 832-822-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax: 713-798-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberM6857
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: