Provider Demographics
NPI:1932117124
Name:ROSKOS, STEPHEN R (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:R
Last Name:ROSKOS
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 1:2026 W UNIVERSITY DR STE 8
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-0644
Mailing Address - Country:US
Mailing Address - Phone:940-380-7197
Mailing Address - Fax:940-380-7198
Practice Address - Street 1:2026 W UNIVERSITY DR STE 8
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-0644
Practice Address - Country:US
Practice Address - Phone:940-380-7197
Practice Address - Fax:940-380-7198
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG11842084P0800X
TXG11782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89256XOtherBCBSTXBILLING#
TX2890287Medicaid
TXG1178OtherLICENSE#
TX289028701Medicaid
TX00RZ09Medicare PIN