| S. Richard Roskos, Md, Pa | |
|
3500 Oak Lawn Ave Ste. 215 Dallas TX 75219-4348 | |
| (214) 252-1804 | |
| (214) 526-4610 |
| Full Name | S. Richard Roskos, Md, Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3500 Oak Lawn Ave, Dallas, Texas |
| Authorized Official Name and Position | S. Richard Roskos (PRESIDENT) |
| Authorized Official Contact | 2142521804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S. Richard Roskos, Md, Pa 3500 Oak Lawn Ave Ste. 215 Dallas TX 75219-4348 Ph: (214) 252-1804 | S. Richard Roskos, Md, Pa 3500 Oak Lawn Ave Ste. 215 Dallas TX 75219-4348 Ph: (214) 252-1804 |
| NPI Number | 1215093554 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 07/26/2012 |
| Medicare PECOS PAC ID | 6204005093 |
|---|---|
| Medicare Enrollment ID | O20110811000885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215093554 | NPI | - | NPPES |
| 035798001 | Medicaid | TX | |
| 289028701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G1178 (Texas) | Primary |
| Provider Name | Stephen R Roskos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932117124 PECOS PAC ID: 2163437427 Enrollment ID: I20060208000575 |
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