Provider Demographics
NPI:1326140195
Name:ROSENBLATT, HOWARD MAX (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:MAX
Last Name:ROSENBLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 BARBARA JORDAN BLVD
Mailing Address - Street 2:#200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3078
Mailing Address - Country:US
Mailing Address - Phone:512-628-1870
Mailing Address - Fax:512-628-1871
Practice Address - Street 1:1301 BARBARA JORDAN BLVD
Practice Address - Street 2:#200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3078
Practice Address - Country:US
Practice Address - Phone:512-628-1870
Practice Address - Fax:512-628-1871
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1759207K00000X, 207KI0005X, 208000000X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132935108Medicaid
TX132935108Medicaid
TX8J4481Medicare PIN