Provider Demographics
NPI:1790704237
Name:ROSSON, DOROTHY ANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:ANNETTE
Last Name:ROSSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:575 HILL COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6024
Mailing Address - Country:US
Mailing Address - Phone:830-258-7762
Mailing Address - Fax:830-258-7098
Practice Address - Street 1:575 HILL COUNTRY DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-258-7090
Practice Address - Fax:830-258-7098
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2004207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000D54Z0Medicaid
TX1228306-03OtherTPI
TX00D54ZOtherBLUE CROSS/BLUE SHIELD
TX110034733OtherRAILROAD MEDICARE
TX8L15783Medicare PIN
TX1228306-03OtherTPI
TX110034733OtherRAILROAD MEDICARE