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General NPI Number Information
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NPI Number | 1134399934
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Entity Type | Organization
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Legal Business Name | OURANIA S. ROSSETOS
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 12414 ALDERBROOK DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78758-2482
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Country | US
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Telephone | 512-388-3737
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Fax | 512-388-3741
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Provider Business Mailing Address
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Address Line | 12414 ALDERBROOK DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78758-2482
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Country | US
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Telephone | 512-388-3737
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Fax | 512-388-3741
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Authorized Official
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Title or Position | OWNER
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Name | DR. OURANIA ROSSETOS
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Credential | M.D.
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Telephone | 512-388-3737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K3844
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License Number State | TX
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