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NPI Code Detail

MEDICARE: ROSE IMAGING SPECIALISTS, PA

MEDICARE: ROSE IMAGING SPECIALISTS, PA
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
12085R0204XVascular & Interventional Radiology Physician
22085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1699275271
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROSE IMAGING SPECIALISTS, PA
Provider Business Mailing Address
First Line : PO BOX 203268
Second Line :
City : DALLAS
State : TX
Zip : 75320-3268
Country : US
Telephone Number : 972-360-1345
Fax Number : 972-360-1399
Provider Business Practice Location Address
First Line : 6807 EMMETT F LOWRY EXPY STE 308
Second Line :
City : TEXAS CITY
State : TX
Zip : 77591-2547
Country : US
Telephone Number : 903-783-0624
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : SHARLEE LEBLEU
Credential :
Telephone Number : 480-321-7026
Provider Enumeration Date : 02/20/2018
Last Update Date : 07/12/2024

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