Individual
JOHN M ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 MEDICAL DR, PALESTINE, TX 75801-4781
(903) 723-6092
(903) 723-5149
Mailing address
111 MEDICAL DR, PALESTINE, TX 75801-4781
(903) 723-6092
(903) 723-5149
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J7169
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136405102
—
TX
Enumeration date
08/16/2005
Last updated
06/14/2011
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