Provider Demographics
NPI:1457043754
Name:ROSALES, MARIA NELI (TRANSPORTATION MED)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:NELI
Last Name:ROSALES
Suffix:
Gender:F
Credentials:TRANSPORTATION MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 SANTA ANA AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO VIEJO
Mailing Address - State:TX
Mailing Address - Zip Code:78575-9725
Mailing Address - Country:US
Mailing Address - Phone:956-346-6593
Mailing Address - Fax:
Practice Address - Street 1:412 SANTA ANA AVE
Practice Address - Street 2:
Practice Address - City:RANCHO VIEJO
Practice Address - State:TX
Practice Address - Zip Code:78575-9725
Practice Address - Country:US
Practice Address - Phone:956-346-6593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10516711172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty