Healthcare Provider Details

I. General information

NPI: 1265551758
Provider Name (Legal Business Name): CITY OF ROSENBERG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 5TH ST
ROSENBERG TX
77471-2614
US

IV. Provider business mailing address

PO BOX 691363
HOUSTON TX
77269-1363
US

V. Phone/Fax

Practice location:
  • Phone: 832-595-3600
  • Fax: 832-595-3601
Mailing address:
  • Phone: 281-397-0397
  • Fax: 281-397-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number079006
License Number StateTX

VIII. Authorized Official

Name: KAREN P LAAKE
Title or Position: ACCOUNTS REPRESENTATIVE
Credential:
Phone: 281-397-0397