Provider Demographics
NPI:1174823991
Name:SENEGAL, ROSE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:
Last Name:SENEGAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 SHADY COVE CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1339
Mailing Address - Country:US
Mailing Address - Phone:713-436-4624
Mailing Address - Fax:
Practice Address - Street 1:2302 SHADY COVE CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1339
Practice Address - Country:US
Practice Address - Phone:713-436-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605607163W00000X, 247000000X, 332B00000X
TX1132841363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies