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General NPI Number Information
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NPI Number | 1699364307
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Entity Type | Individual
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Provider Name | ROSE KNIGHT
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Gender | Female
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Dates
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Enumeration Date | 01/16/2021
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Last Update Date | 01/16/2021
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Provider Practice Location Address
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Address Line | 3302 GASTON AVE # 180
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City | DALLAS
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State | TX
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Zip | 75246-2013
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Country | US
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Telephone | 214-499-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 3302 GASTON AVE # 3180
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City | DALLAS
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State | TX
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Zip | 75246-2013
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Country | US
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Telephone |
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA14130
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License Number State | TX
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