Provider Demographics
NPI:1568179661
Name:ROSEMORE, EVELYN SPIRA (MD)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:SPIRA
Last Name:ROSEMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 CAVENDISH CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4231
Mailing Address - Country:US
Mailing Address - Phone:214-636-0202
Mailing Address - Fax:
Practice Address - Street 1:5516 CAVENDISH CT
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4231
Practice Address - Country:US
Practice Address - Phone:214-636-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12251208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice