MEDICARE: MRS. TEREA S ROSE

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	246RP1900X	Phlebotomy Technician		TX

General Provider Information

NPI Number	:	1588528889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TEREA S ROSE

Provider Business Mailing Address
First Line	:	2257 N LOOP 336 W STE 140
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-3566
Country	:	US
Telephone Number	:	832-872-6881
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 WILSON RD APT 421
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-1676
Country	:	US
Telephone Number	:	936-720-0727
Fax Number	:

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

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ MRS. TEREA S ROSE ” Practice Location

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