Organization
PEARLAND DIAGNOSTIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH H ROOSTH M.D. (OWNER)
(281) 997-8181
Entity
Organization
Contact information
Practice address
1834 BROADWAY ST, SUITE 102, PEARLAND, TX 77581-5668
(281) 997-8181
(281) 997-8184
Mailing address
1834 BROADWAY ST, SUITE 102, PEARLAND, TX 77581-5668
(281) 997-8181
(281) 997-8184
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MDH7345
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128481204
—
TX
Enumeration date
11/24/2008
Last updated
06/19/2012
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