Provider Demographics
NPI:1194746172
Name:ROSALES, OSCAR R (MD)
Entity type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:R
Last Name:ROSALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 FANNIN ST STE 801
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5870
Mailing Address - Country:US
Mailing Address - Phone:713-790-0841
Mailing Address - Fax:713-790-9663
Practice Address - Street 1:5115 FANNIN ST STE 801
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5870
Practice Address - Country:US
Practice Address - Phone:713-790-0841
Practice Address - Fax:713-790-9663
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9414207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125502806Medicaid
TX125502805Medicaid
TX8DF510OtherBCBS
B64499Medicare UPIN
TX8DF510OtherBCBS