Provider Demographics
NPI:1194981696
Name:WOMACK, ROSALYN L (DO)
Entity type:Individual
Prefix:DR
First Name:ROSALYN
Middle Name:L
Last Name:WOMACK
Suffix:
Gender:
Credentials:DO
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Mailing Address - Street 1:6800 PARK TEN BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4293
Mailing Address - Country:US
Mailing Address - Phone:210-261-1060
Mailing Address - Fax:210-358-9183
Practice Address - Street 1:5372 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3558
Practice Address - Country:US
Practice Address - Phone:210-261-1600
Practice Address - Fax:210-615-5721
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDO2025-00242084P0800X
TXN67732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry