MEDICARE: DR. ANGIE ROSANNE TARAS M.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
1	208600000X	Surgery Physician	R1660	TX

General Provider Information

NPI Number	:	1841410479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGIE ROSANNE TARAS M.D.

Provider Business Mailing Address
First Line	:	2760 WYNFIELD LN
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-3352
Country	:	US
Telephone Number	:	312-715-7552
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 GREENVILLE AVE STE 400
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-5186
Country	:	US
Telephone Number	:	214-600-7590
Fax Number	:

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	05/30/2026

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