Provider Demographics
NPI:1548573801
Name:ANIBAL F ROSSEL MD PA
Entity type:Organization
Organization Name:ANIBAL F ROSSEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANIBAL
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:713-910-2244
Mailing Address - Street 1:8939 CLEARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-1801
Mailing Address - Country:US
Mailing Address - Phone:713-910-2244
Mailing Address - Fax:713-910-3444
Practice Address - Street 1:8939 CLEARWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-1801
Practice Address - Country:US
Practice Address - Phone:713-910-2244
Practice Address - Fax:713-910-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9415207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133460905Medicaid
TX00J54ZMedicare PIN
TX133460905Medicaid