Provider Demographics
NPI:1275993222
Name:FREEMAN, ROXANE GILLAM
Entity Type:Individual
Prefix:MRS
First Name:ROXANE
Middle Name:GILLAM
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 HIGHWAY 365 STE 440
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6258
Mailing Address - Country:US
Mailing Address - Phone:832-552-0674
Mailing Address - Fax:
Practice Address - Street 1:2300 HIGHWAY 365 STE 440
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6258
Practice Address - Country:US
Practice Address - Phone:409-433-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator