Jimmy Rosales Jr., PA
Physician Assistant in Conroe, TX. Individual provider (NPI-1).
NPI number1124456892
StatusActive
Last updated in NPPESMay 15, 2018
Details
- NPI
- 1124456892
- Entity type
- Individual (NPI-1)
- Name
- Jimmy Rosales Jr.
- Credential
- PA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 16, 2013
- Last updated
- May 15, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA01304 | TX | Yes |
Practice location
1150 N Loop 336 WConroe, TX 77301
Phone 936-494-3777
Mailing address
1150 N Loop 336 WConroe, TX 77301-1156
Phone 936-494-3777
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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