Provider Demographics
NPI:1437608916
Name:TIRADO, ROSEMARY (PTA)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:TIRADO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2062 ASPEN GLADE DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1758
Mailing Address - Country:US
Mailing Address - Phone:832-368-8334
Mailing Address - Fax:
Practice Address - Street 1:2062 ASPEN GLADE DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1758
Practice Address - Country:US
Practice Address - Phone:832-368-8334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2089663283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital