Provider Demographics
NPI:1013929272
Name:ROSAS, CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:ROSAS
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 1:704 PAREDES LINE RD STE A
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2442
Mailing Address - Country:US
Mailing Address - Phone:956-831-7111
Mailing Address - Fax:956-831-7119
Practice Address - Street 1:704 PAREDES LINE RD STE A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2442
Practice Address - Country:US
Practice Address - Phone:956-831-7111
Practice Address - Fax:956-831-7119
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079962901Medicaid
TXM0050128OtherDPS
TXAR1883796OtherDEA
TXE34180Medicare UPIN