Provider Demographics
NPI:1295124675
Name:ROSSEL MEDICAL CLINIC PLLC
Entity type:Organization
Organization Name:ROSSEL MEDICAL CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANIBAL
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-910-2244
Mailing Address - Street 1:PO BOX 732712
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-2712
Mailing Address - Country:US
Mailing Address - Phone:713-910-2244
Mailing Address - Fax:713-910-3444
Practice Address - Street 1:8939 CLEARWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-1801
Practice Address - Country:US
Practice Address - Phone:713-910-2244
Practice Address - Fax:713-910-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty