Healthcare Provider Details
I. General information
NPI: 1568519601
Provider Name (Legal Business Name): BERNARD ALLAN ROSENBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/04/2007
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7107 F.M. 2920 RD. SUITE 200
SPRING TX
77379-2213
US
IV. Provider business mailing address
7107 F.M. 2920 RD. SUITE 200
SPRING TX
77379-2213
US
V. Phone/Fax
- Phone: 281-580-8086
- Fax: 281-580-7129
- Phone: 281-580-8086
- Fax: 281-580-7129
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | F1950 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: