Provider Demographics
NPI:1376548396
Name:ROSENSTEIN, JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:
Last Name:ROSENSTEIN
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 1:800 W ARBROOK BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-4327
Mailing Address - Country:US
Mailing Address - Phone:817-467-5551
Mailing Address - Fax:817-465-2775
Practice Address - Street 1:800 W ARBROOK BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4327
Practice Address - Country:US
Practice Address - Phone:817-467-5551
Practice Address - Fax:817-465-2775
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5727207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00GQ94Medicare PIN