Provider Demographics
NPI:1669425971
Name:LANGE, ROSE LYNN CARLOTO (MD)
Entity type:Individual
Prefix:DR
First Name:ROSE LYNN
Middle Name:CARLOTO
Last Name:LANGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:608 TIFFANY TRL
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5644
Mailing Address - Country:US
Mailing Address - Phone:972-671-9727
Mailing Address - Fax:972-671-9727
Practice Address - Street 1:1701 N COLLINS BLVD
Practice Address - Street 2:#300
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-231-3134
Practice Address - Fax:972-231-3234
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK6876208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G81367Medicare UPIN