=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447063052
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSEMARY AKAETTE DUAMLONG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2025
-----------------------------------------------------
Last Update Date | 01/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1000 HERITAGE CENTER CIR STE 160
-----------------------------------------------------
City | ROUND ROCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78664-4463
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-551-9159
-----------------------------------------------------
Fax | 855-855-5188
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1940 INDIAN GRASS DR
-----------------------------------------------------
City | ROYSE CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75189-5586
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-740-7407
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------