Provider Demographics
NPI:1073629259
Name:ROCKWOOD, KATHLEEN BARRETT (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:BARRETT
Last Name:ROCKWOOD
Suffix:
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 1:598 N UNION
Mailing Address - Street 2:STE 350
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130
Mailing Address - Country:US
Mailing Address - Phone:830-625-5375
Mailing Address - Fax:830-625-5531
Practice Address - Street 1:598 N UNION
Practice Address - Street 2:STE 350
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130
Practice Address - Country:US
Practice Address - Phone:830-625-5375
Practice Address - Fax:830-625-5531
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8108207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035670101Medicaid
TX00R95XMedicare PIN
TXB61521Medicare UPIN