Provider Demographics
NPI:1053645812
Name:SEXTON, ROCHELLE MARIE I (MD)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:MARIE
Last Name:SEXTON
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 DELMARVA CT
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-4372
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1321 WATERS EDGE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-1232
Practice Address - Country:US
Practice Address - Phone:817-408-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6913207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
P6913OtherTEXAS MEDICAL LICENSE NUMBER