Individual
ALEXANDER CARLOS DE LA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 KITTY HAWK ROAD, UNIVERSAL CITY, TX 78148-3806
(210) 945-2120
Mailing address
910 KITTY HAWK RD, UNIVERSAL CITY, TX 78148-3806
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
327444
TX
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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