Healthcare Provider Details

I. General information

NPI: 1114936416
Provider Name (Legal Business Name): MICHAEL J ROSENBLATT MD AND KATHRYN A ZIDEK MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MEDICAL CENTER BLVD
WEBSTER TX
77598-4301
US

IV. Provider business mailing address

18333 EGRET BAY BLVD STE 140
HOUSTON TX
77058-3239
US

V. Phone/Fax

Practice location:
  • Phone: 832-224-9500
  • Fax:
Mailing address:
  • Phone: 281-218-8797
  • Fax: 281-286-7557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL J ROSENBLATT
Title or Position: OWNER
Credential: MD
Phone: 281-218-8797