Provider Demographics
NPI:1972709020
Name:AMAR, ROSALINDA
Entity type:Individual
Prefix:MRS
First Name:ROSALINDA
Middle Name:
Last Name:AMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 E COWAN TER
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-4042
Mailing Address - Country:US
Mailing Address - Phone:956-459-1168
Mailing Address - Fax:956-544-8800
Practice Address - Street 1:2505 BOCA CHICA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2309
Practice Address - Country:US
Practice Address - Phone:956-544-8800
Practice Address - Fax:956-544-8800
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194041302Medicaid
TX6078240001Medicare NSC