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General NPI Number Information
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NPI Number | 1275084881
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Entity Type | Individual
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Provider Name | STEVEN LOUIS ROSENTHAL PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 11/05/2016
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Provider Practice Location Address
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Address Line | 1301 W 38TH ST MPT, SUITE 113
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City | AUSTIN
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State | TX
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Zip | 78705-1000
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Country | US
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Telephone | 512-324-3395
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Fax | 512-324-3399
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Provider Business Mailing Address
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Address Line | 1301 W 38TH ST MPT, SUITE 113
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City | AUSTIN
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State | TX
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Zip | 78705-1000
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Country | US
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Telephone | 512-324-3395
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Fax | 512-324-3399
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA10897
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA10897
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License Number State | TX
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