Provider Demographics
NPI:1083622732
Name:DUBIEL, ROSEMARY A (DO)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:A
Last Name:DUBIEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5716
Mailing Address - Country:US
Mailing Address - Phone:972-487-5574
Mailing Address - Fax:972-487-5139
Practice Address - Street 1:800 N SHILOH RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5716
Practice Address - Country:US
Practice Address - Phone:972-487-5574
Practice Address - Fax:972-487-5139
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8673208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1668998-01Medicaid
TX1668998-02Medicaid
TX8BR092OtherBCBS
TX1668998-01Medicaid
TX8B8657Medicare PIN
TX8BR092OtherBCBS
TXP00191032Medicare PIN