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AVIVA TZIPORAH ROGOZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4550 N BRAESWOOD BLVD APT 331, HOUSTON, TX 77096-2883
(216) 401-9574
Mailing address
4550 N BRAESWOOD BLVD APT 331, HOUSTON, TX 77096-2883
(216) 401-9574

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA13409
PHYSICIAN ASSISTANT LICENSE
TX
Enumeration date
07/31/2020
Last updated
07/31/2020
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