Basic Information
| Provider Information | |||||||||
| NPI: | 1710153390 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROSA OF DENTON LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 320 SEVEN SPRINGS WAY | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370274537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152501798 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2900 N I35 | ||||||||
| Address2: | SUITE 119 | ||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762015143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403878000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2008 | ||||||||
| LastUpdateDate: | 06/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | MERRILL | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6152501798 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | RADIATION ONCOLOGY SERVICES OF AMERICA INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.