Provider Demographics
NPI:1104610625
Name:ROSE, DANIEL ARMEN
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ARMEN
Last Name:ROSE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7615 KENNEDY HILL DR., BUILDING #2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235
Mailing Address - Country:US
Mailing Address - Phone:210-890-4243
Mailing Address - Fax:
Practice Address - Street 1:7615 KENNEDY HILL DR., BUILDING #2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235
Practice Address - Country:US
Practice Address - Phone:210-890-4243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program