Provider Demographics
NPI:1194840769
Name:JARED C. ROSENBERG, DC, P.A.
Entity Type:Organization
Organization Name:JARED C. ROSENBERG, DC, P.A.
Other - Org Name:FAMILY CARE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-554-5308
Mailing Address - Street 1:251 MEDICAL CENTER BLVD
Mailing Address - Street 2:300A
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4242
Mailing Address - Country:US
Mailing Address - Phone:281-554-5308
Mailing Address - Fax:281-605-5539
Practice Address - Street 1:251 MEDICAL CENTER BLVD
Practice Address - Street 2:300A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4242
Practice Address - Country:US
Practice Address - Phone:281-554-5308
Practice Address - Fax:281-605-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty