Provider Demographics
NPI:1639150634
Name:ROSEN, ALAN (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:ROSEN
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 1:13802 CENTERFIELD DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6044
Mailing Address - Country:US
Mailing Address - Phone:281-737-0902
Mailing Address - Fax:281-737-0926
Practice Address - Street 1:13802 CENTERFIELD DR
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6044
Practice Address - Country:US
Practice Address - Phone:281-737-0902
Practice Address - Fax:281-737-0926
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3843207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH0103891OtherDPS
TX118854206Medicaid
TX8FX337OtherBLUE CROSS BLUE SHIELD
TX118854204Medicaid
TX8FK542OtherBLUE CROSS BLUE SHIELD
TX118854205Medicaid
TXK3843OtherSTATE LICENSE
TXK3843OtherSTATE LICENSE
TX118854205Medicaid
TX118854204Medicaid
TXBR3451642OtherDEA
TX118854206Medicaid