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NPI Code Detail

MEDICARE: ROSELL JENKINS PH.D.

MEDICARE:   ROSELL  JENKINS  PH.D.
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
1103TC0700XClinical Psychologist31916TX

Other Identifiers

General Provider Information

NPI Number : 1558307736
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSELL JENKINS PH.D.
Provider Business Mailing Address
First Line : 505 N SAM HOUSTON PKWY E
Second Line : SUITE 502
City : HOUSTON
State : TX
Zip : 77060-4018
Country : US
Telephone Number : 281-447-9355
Fax Number : 281-447-9356
Provider Business Practice Location Address
First Line : 505 N SAM HOUSTON PKWY E
Second Line : SUITE 502
City : HOUSTON
State : TX
Zip : 77060-4018
Country : US
Telephone Number : 281-447-9355
Fax Number : 281-447-9356
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/08/2007

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