Provider Demographics
NPI:1225116809
Name:ROSEWOOD ENT, LLP
Entity Type:Organization
Organization Name:ROSEWOOD ENT, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:RAYNER
Authorized Official - Last Name:DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-781-9660
Mailing Address - Street 1:2500 TANGLEWILDE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2123
Mailing Address - Country:US
Mailing Address - Phone:713-781-9660
Mailing Address - Fax:713-974-3672
Practice Address - Street 1:2500 TANGLEWILDE
Practice Address - Street 2:SUITE 160
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2123
Practice Address - Country:US
Practice Address - Phone:713-781-9660
Practice Address - Fax:713-974-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00P014Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER