Healthcare Provider Details

I. General information

NPI: 1144547423
Provider Name (Legal Business Name): JOSEPH ROSEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 01/28/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 FANNIN ST SUITE 1130
HOUSTON TX
77054-1920
US

IV. Provider business mailing address

1883 DART ST
HOUSTON TX
77007-4432
US

V. Phone/Fax

Practice location:
  • Phone: 713-794-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberN6627
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberBP10028765
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: