Provider Demographics
NPI:1376149252
Name:GATHOGO, ROSEMARY (NP)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:GATHOGO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7002 RAMBLING TREE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3796
Mailing Address - Country:US
Mailing Address - Phone:832-466-4378
Mailing Address - Fax:
Practice Address - Street 1:7002 RAMBLING TREE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3796
Practice Address - Country:US
Practice Address - Phone:832-466-4378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020376363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner