Provider Demographics
NPI:1134399934
Name:OURANIA S. ROSSETOS
Entity type:Organization
Organization Name:OURANIA S. ROSSETOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OURANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSETOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-388-3737
Mailing Address - Street 1:12414 ALDERBROOK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2482
Mailing Address - Country:US
Mailing Address - Phone:512-388-3737
Mailing Address - Fax:512-388-3741
Practice Address - Street 1:12414 ALDERBROOK DR STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2482
Practice Address - Country:US
Practice Address - Phone:512-388-3737
Practice Address - Fax:512-388-3741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3844207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty