Provider Demographics
NPI:1063416519
Name:ROESER, ROSS JOSEPH (PHD)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:JOSEPH
Last Name:ROESER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 MARYDALE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-3034
Mailing Address - Country:US
Mailing Address - Phone:214-905-3001
Mailing Address - Fax:214-905-3022
Practice Address - Street 1:601 S TOOL DR
Practice Address - Street 2:
Practice Address - City:KEMP
Practice Address - State:TX
Practice Address - Zip Code:75143-1959
Practice Address - Country:US
Practice Address - Phone:903-432-1932
Practice Address - Fax:903-432-1943
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
TX50234231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist