Provider Demographics
NPI:1326330044
Name:ROSALES, MARISA BYARS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:BYARS
Last Name:ROSALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:
Other - Last Name:BYARS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2146
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071
Mailing Address - Country:US
Mailing Address - Phone:972-569-9904
Mailing Address - Fax:972-569-9943
Practice Address - Street 1:5333 W. UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071
Practice Address - Country:US
Practice Address - Phone:972-569-9904
Practice Address - Fax:972-569-9943
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5267208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics