MEDICARE: DR. ERIC SCOTT ROSENBERGER MD

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	2082S0099X	Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician	Q7457	TX

General Provider Information

NPI Number	:	1922323443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC SCOTT ROSENBERGER MD

Provider Business Mailing Address
First Line	:	10815 RR 2222 BLDG 3C
Second Line	:	STE. 101
City	:	AUSTIN
State	:	TX
Zip	:	78730-1159
Country	:	US
Telephone Number	:	512-717-9475
Fax Number	:	512-498-7535

Provider Business Practice Location Address
First Line	:	10815 RR 2222 BLDG 3C
Second Line	:	STE. 101
City	:	AUSTIN
State	:	TX
Zip	:	78730-1159
Country	:	US
Telephone Number	:	512-717-9475
Fax Number	:	512-498-7535

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

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	01/12/2017

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