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NPI Code Detail

MEDICARE: DR. GLORIA M ROSE PHD, NP-C, FNP-BC

MEDICARE: DR. GLORIA M ROSE PHD, NP-C, FNP-BC
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
1363LF0000XFamily Nurse Practitioner506274TX

General Provider Information

NPI Number : 1487995072
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLORIA M ROSE PHD, NP-C, FNP-BC
Provider Business Mailing Address
First Line : 2103 FOUNTAIN DR
Second Line :
City : SUGAR LAND
State : TX
Zip : 77478-6012
Country : US
Telephone Number : 281-989-4298
Fax Number : 281-240-0018
Provider Business Practice Location Address
First Line : 6718 HIGHWAY 6 S
Second Line :
City : HOUSTON
State : TX
Zip : 77083-1512
Country : US
Telephone Number : 832-328-0044
Fax Number : 832-328-0042
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2013
Last Update Date : 03/07/2013

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