Individual
ROSEMARY ELLEN DETWEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6100 HARRIS PARKWAY, FORT WORTH, TX 76132-4126
(214) 638-2000
(214) 237-1864
Mailing address
1355 RIVER BEND DRIVE, DALLAS, TX 75247-4915
(214) 638-2000
(214) 237-1864
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H5868
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124415405
—
TX
01
—
8S1225
BCBS
TX
01
—
P00281152
RAILROAD MEDICARE
TX
Enumeration date
07/18/2006
Last updated
03/23/2015
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