Provider Demographics
NPI:1891797460
Name:TANG, ROSA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:A
Last Name:TANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSA
Other - Middle Name:A
Other - Last Name:TANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:505 J DAVIS ARMISTEAD BLDG
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77204-2020
Mailing Address - Country:US
Mailing Address - Phone:713-942-2187
Mailing Address - Fax:713-942-0265
Practice Address - Street 1:2617C W HOLCOMBE BLVD
Practice Address - Street 2:PMB 575
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1601
Practice Address - Country:US
Practice Address - Phone:713-942-2187
Practice Address - Fax:713-942-0265
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
TXE4710207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC22475Medicare UPIN