Provider Demographics
NPI:1992174726
Name:ROSAS, CHRISTY ANIZZA (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:ANIZZA
Last Name:ROSAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78291-0276
Mailing Address - Country:US
Mailing Address - Phone:210-828-2503
Mailing Address - Fax:210-828-5731
Practice Address - Street 1:111 DALLAS ST STE 200A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1201
Practice Address - Country:US
Practice Address - Phone:210-225-6508
Practice Address - Fax:210-225-1486
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09994363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA09994OtherTEXAS LICENSE NUMBER