Healthcare Provider Details

I. General information

NPI: 1730326679
Provider Name (Legal Business Name): PATRICIA LIZETTE ROSILLO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BROOKLYN AVE STE 320
SAN ANTONIO TX
78212-4810
US

IV. Provider business mailing address

1200 BROOKLYN AVE STE 320
SAN ANTONIO TX
78212-4810
US

V. Phone/Fax

Practice location:
  • Phone: 210-229-7242
  • Fax: 210-227-5092
Mailing address:
  • Phone: 210-229-7242
  • Fax: 210-227-5092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN9404
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN9404
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: