Provider Demographics
NPI:1184903163
Name:MARKOSE, ROXY ANN (OD)
Entity type:Individual
Prefix:DR
First Name:ROXY
Middle Name:ANN
Last Name:MARKOSE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S PLANO RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4512
Mailing Address - Country:US
Mailing Address - Phone:972-231-7642
Mailing Address - Fax:
Practice Address - Street 1:601 S PLANO RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4512
Practice Address - Country:US
Practice Address - Phone:972-231-7642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7707T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist