Provider Demographics
NPI:1508697442
Name:ROSE DERMATOLOGY
Entity type:Organization
Organization Name:ROSE DERMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-838-2909
Mailing Address - Street 1:10630 BRAUN RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2734
Mailing Address - Country:US
Mailing Address - Phone:210-838-2909
Mailing Address - Fax:210-905-0121
Practice Address - Street 1:10630 BRAUN RD STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2734
Practice Address - Country:US
Practice Address - Phone:210-838-2909
Practice Address - Fax:210-905-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty