Individual
DR. JACK W ROSTAS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4101 22ND PL, LUBBOCK, TX 79410-1121
(806) 799-7928
(806) 788-8560
Mailing address
3509 22ND ST, LUBBOCK, TX 79410-1307
(806) 799-7928
(806) 788-8560
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
036143962
IL
2086X0206X
Surgical Oncology Physician
Primary
T5200
TX
Other
Enumeration date
05/22/2008
Last updated
08/17/2023
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