Provider Demographics
NPI:1689814451
Name:MCCOMMON, ROSEMARY
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:MCCOMMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17150 BUTTE CREEK RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2371
Mailing Address - Country:US
Mailing Address - Phone:832-484-1737
Mailing Address - Fax:832-484-1739
Practice Address - Street 1:17150 BUTTE CREEK RD
Practice Address - Street 2:SUITE 145
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2371
Practice Address - Country:US
Practice Address - Phone:832-484-1737
Practice Address - Fax:832-484-1739
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009702251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677909Medicare Oscar/Certification