MEDICARE: DONNA MICHELLE ROSS L.P.C.

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	101Y00000X	Counselor	15258	TX
2	101YM0800X	Mental Health Counselor	15258	TX
3	101YP2500X	Professional Counselor	15258	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00003881LC	OTHER	TX	BCBS PROVIDER NUMBER
2	A073037	OTHER	TX	VALUE OPTIONS VENDOR #
3	125586	OTHER	TX	SUPERIOR HEALTHPLAN NETWO
4	A864796	OTHER	TX	VALUE OPTIONS VENDOR #

General Provider Information

NPI Number	:	1760433072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA MICHELLE ROSS L.P.C.

Provider Business Mailing Address
First Line	:	104 E INDUSTRIAL BLVD
Second Line	:
City	:	EARLY
State	:	TX
Zip	:	76802-2354
Country	:	US
Telephone Number	:	325-649-9313
Fax Number	:	325-646-9452

Provider Business Practice Location Address
First Line	:	104 E INDUSTRIAL BLVD
Second Line	:
City	:	EARLY
State	:	TX
Zip	:	76802-2354
Country	:	US
Telephone Number	:	325-649-9313
Fax Number	:	325-646-9452

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	09/11/2025

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Directions to “ DONNA MICHELLE ROSS L.P.C.” Practice Location

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