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General NPI Number Information
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NPI Number | 1790067569
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Entity Type | Organization
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Legal Business Name | NATASHA E. ROSE, MD, PA
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 3827 ADDISON DR
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City | PEARLAND
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State | TX
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Zip | 77584-3023
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Country | US
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Telephone | 281-865-2884
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Fax | 281-412-0956
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Provider Business Mailing Address
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Address Line | PO BOX 841706
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City | PEARLAND
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State | TX
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Zip | 77584-0021
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Country | US
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Telephone | 281-865-2884
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Fax | 281-412-0956
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | NATASHA EADDY ROSE
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Credential | M.D., P.A.
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Telephone | 281-865-2884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | M7155
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License Number State | TX
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