Individual
WADE RONALD ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6560 FANNIN ST, SUITE 1750, HOUSTON, TX 77030-2761
(713) 790-4830
(713) 793-7824
Mailing address
6560 FANNIN ST, SUITE 1750, HOUSTON, TX 77030-2761
(713) 790-4830
(713) 793-7824
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G0029
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124931002
—
TX
05
—
124931005
—
TX
01
—
89819B
BCBS
TX
01
—
8DW161
BLUE CROSS BLUE SHIELD
TX
01
—
8GD960
BCBS
TX
01
—
P01263888
RR MEDICARE
TX
Enumeration date
07/26/2005
Last updated
01/17/2017
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