Healthcare Provider Details

I. General information

NPI: 1689676868
Provider Name (Legal Business Name): JOY ROSNER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 SWEETWATER BLVD
SUGAR LAND TX
77479-3010
US

IV. Provider business mailing address

4511 SWEETWATER BLVD
SUGAR LAND TX
77479-3010
US

V. Phone/Fax

Practice location:
  • Phone: 281-265-2020
  • Fax: 281-265-2029
Mailing address:
  • Phone: 281-265-2020
  • Fax: 281-265-2029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3558T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: