Provider Demographics
NPI:1619238912
Name:ROSENBERG, CHRISTA (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:
Other - Last Name:LOVETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4105 GREENBRIER DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6636
Mailing Address - Country:US
Mailing Address - Phone:501-538-4877
Mailing Address - Fax:
Practice Address - Street 1:11661 PRESTON RD STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6199
Practice Address - Country:US
Practice Address - Phone:844-814-2896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251819208000000X
TXS0371208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics