Provider Demographics
NPI:1285961961
Name:ROBLEDO, ROSEMARIE (DO)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:ROBLEDO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3537 S I 35 E STE 318
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6870
Mailing Address - Country:US
Mailing Address - Phone:940-287-6170
Mailing Address - Fax:
Practice Address - Street 1:3537 S I 35 E STE 318
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6870
Practice Address - Country:US
Practice Address - Phone:940-287-6170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8107208600000X, 2086S0102X
LA000397208600000X
LADO.0003972086S0102X
NJ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program