Individual
CALLASANDRA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
700 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845-6441
(979) 207-0100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
S2488
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315075272
CONTROLLED SUBSTANCE
MI
Enumeration date
05/02/2016
Last updated
12/23/2020
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