MEDICARE: DR. JOEL D. ROSEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	H1197	TX

General Provider Information

NPI Number	:	1134191364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL D. ROSEN MD

Provider Business Mailing Address
First Line	:	13210 TRENTWOOD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78231-2256
Country	:	US
Telephone Number	:	210-286-6118
Fax Number	:

Provider Business Practice Location Address
First Line	:	13210 TRENTWOOD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78231-2256
Country	:	US
Telephone Number	:	210-286-6118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	08/31/2023

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