Provider Demographics
NPI:1679966253
Name:COELHO, ROSIE (LAC, MACOM)
Entity type:Individual
Prefix:
First Name:ROSIE
Middle Name:
Last Name:COELHO
Suffix:
Gender:F
Credentials:LAC, MACOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TX
Mailing Address - Zip Code:76227-7665
Mailing Address - Country:US
Mailing Address - Phone:512-775-7504
Mailing Address - Fax:
Practice Address - Street 1:8400 STACY RD STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2144
Practice Address - Country:US
Practice Address - Phone:512-775-7504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01539171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist