Provider Demographics
NPI:1407883580
Name:ROSEN, VALERIE CYRENE (M D)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:CYRENE
Last Name:ROSEN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6309
Mailing Address - Country:US
Mailing Address - Phone:512-324-3380
Mailing Address - Fax:
Practice Address - Street 1:3501 MILLS AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6309
Practice Address - Country:US
Practice Address - Phone:512-324-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP81832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX322759YKYMMedicare PIN
TX322759YKYMMedicare PIN