Provider Demographics
NPI:1639714710
Name:ROSAS PROVIDER SERVICES, LLC.
Entity Type:Organization
Organization Name:ROSAS PROVIDER SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:GUDALUPE
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-529-7398
Mailing Address - Street 1:3208 PTJ DR
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-8607
Mailing Address - Country:US
Mailing Address - Phone:956-529-7398
Mailing Address - Fax:956-338-5736
Practice Address - Street 1:3208 PTJ DR
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78572-8607
Practice Address - Country:US
Practice Address - Phone:956-777-4088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty