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General NPI Number Information
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NPI Number | 1376031211
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Entity Type | Organization
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Legal Business Name | ROSES, L.L.C.
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 9411 DUGAS DR STE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78245-1002
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Country | US
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Telephone | 210-674-2700
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Fax | 210-674-4591
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Provider Business Mailing Address
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Address Line | 9411 DUGAS DR STE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78245-1002
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Country | US
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Telephone | 210-674-2700
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Fax | 210-674-4591
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/PRESIDENT
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Name | DR. RAMON ROSALES JR.
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Credential | D.C.
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Telephone | 210-674-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6111
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License Number State | TX
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