Provider Demographics
NPI:1912925124
Name:ROSENBERG, MARSHA Y (OD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:Y
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 S STEMMONS FWY
Mailing Address - Street 2:STE E
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8777
Mailing Address - Country:US
Mailing Address - Phone:972-315-5202
Mailing Address - Fax:972-315-3083
Practice Address - Street 1:2410 S STEMMONS FWY
Practice Address - Street 2:STE E
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8777
Practice Address - Country:US
Practice Address - Phone:972-315-5202
Practice Address - Fax:972-315-3083
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2440TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist