Provider Demographics
NPI:1265538730
Name:ROZAS, MARGARET V (RPT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:V
Last Name:ROZAS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E SAINT PETER ST
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-4009
Mailing Address - Country:US
Mailing Address - Phone:337-896-6686
Mailing Address - Fax:337-896-8891
Practice Address - Street 1:204 E SAINT PETER ST
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-4009
Practice Address - Country:US
Practice Address - Phone:337-896-6686
Practice Address - Fax:337-896-8891
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1683973Medicaid
LA12242OtherBCBS INDIVIDUAL ID NUMBER
LAC3526OtherBCBS PROVIDER NUMBER
LAC3526OtherBCBS PROVIDER NUMBER
LA5C593Medicare ID - Type UnspecifiedCLINIC PROVIDER NUMBER