Provider Demographics
NPI:1023118148
Name:ROSEN, PHILIP EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:EUGENE
Last Name:ROSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PHILIP
Other - Middle Name:E
Other - Last Name:ROSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:250 BLOSSOM ST STE 230
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4241
Mailing Address - Country:US
Mailing Address - Phone:281-554-4769
Mailing Address - Fax:281-554-4817
Practice Address - Street 1:250 BLOSSOM ST
Practice Address - Street 2:STE 230
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4204
Practice Address - Country:US
Practice Address - Phone:281-554-4769
Practice Address - Fax:281-554-4817
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6156207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC21295Medicare UPIN
TX8F4807Medicare PIN