Provider Demographics
NPI:1700297405
Name:CARMEN D ROCCO
Entity Type:Organization
Organization Name:CARMEN D ROCCO
Other - Org Name:BROWNSVILLE KIDDIE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-504-6080
Mailing Address - Street 1:95 E PRICE RD BLDG F
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-3531
Mailing Address - Country:US
Mailing Address - Phone:956-504-6080
Mailing Address - Fax:956-504-6419
Practice Address - Street 1:95 E PRICE RD BLDG F
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3531
Practice Address - Country:US
Practice Address - Phone:956-504-6080
Practice Address - Fax:956-504-6419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty