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General NPI Number Information
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NPI Number | 1184736316
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Entity Type | Organization
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Legal Business Name | DALE LANG ROSKOS PHD, P.C.
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4514 COLE AVE STE 1010
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City | DALLAS
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State | TX
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Zip | 75205
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Country | US
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Telephone | 972-392-0088
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Fax | 972-239-4610
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Provider Business Mailing Address
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Address Line | 4514 COLE AVE STE 1010
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City | DALLAS
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State | TX
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Zip | 75205
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Country | US
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Telephone | 972-392-0088
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Fax | 972-239-4610
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Authorized Official
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Title or Position | PRESIDENT
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Name | DALE LANG ROSKOS
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Credential | PH. D.
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Telephone | 972-392-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 22417
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License Number State | TX
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