Provider Demographics
NPI:1679745558
Name:RECAVARREN ASENCIOS, ROSEMARY ABIGAIL (MD)
Entity type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:ABIGAIL
Last Name:RECAVARREN ASENCIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4412 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2970
Mailing Address - Country:US
Mailing Address - Phone:313-510-8171
Mailing Address - Fax:
Practice Address - Street 1:2300 W PIKE BLVD STE 103B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5640
Practice Address - Country:US
Practice Address - Phone:313-510-8171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2752207ZP0102X
PAMD433293208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology