Provider Demographics
NPI:1245759539
Name:ROSE MOUNTAIN MANAGEMENT INC
Entity Type:Organization
Organization Name:ROSE MOUNTAIN MANAGEMENT INC
Other - Org Name:SHARYLAND FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BORJON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-581-2763
Mailing Address - Street 1:2118 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3225
Mailing Address - Country:US
Mailing Address - Phone:956-581-2763
Mailing Address - Fax:
Practice Address - Street 1:2118 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3225
Practice Address - Country:US
Practice Address - Phone:956-581-2763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSE MOUNTAIN MANAGEMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center