Individual
EDWIN O DEL ROSARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8861 DAVIS BLVD, SUITE 100, KELLER, TX 76248-0306
(817) 431-5073
Mailing address
PO BOX 741454, ATLANTA, GA 30374-1454
(817) 431-5073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J4642
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129102306
—
TX
01
—
8U1325
BCBS
TX
01
—
P00680231
RAILROAD MEDICARE
TX
Enumeration date
03/23/2006
Last updated
02/07/2013
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