Mary W Rose, PSY.D, C.B.S.M

Primary specialty

Sleep Specialist (PhD)Taxonomy code 173F00000X

License

3-1557 Issued in TX

Practice address

400 N Texas Avenue
Suite B
Webster, TX 77598

Phone

(281) 316-8400

Fax

(281) 318-8410

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2020 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1265525927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N. TEXAS AVENUE",
            "address_2": "SUITE B",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "77598",
            "telephone_number": "281-316-8400",
            "fax_number": "281-318-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N TEXAS AVENUE",
            "address_2": "SUITE B",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "77598",
            "telephone_number": "281-316-8400",
            "fax_number": "281-318-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MARY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PSY.D, C.B.S.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31557",
            "primary": false
        },
        {
            "code": "173F00000X",
            "taxonomy_group": "",
            "desc": "Sleep Specialist, PhD",
            "state": "TX",
            "license": "3-1557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147062701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendall Renee Roehl, MD
• Jennifer Lee Rollins, M.S., C.G.C.
• Jocelyn Roman, RBT
• Brooke Olivia Romo, APRN
• Tamari Ronen, MD
• Philip Eugene Rosen, M.D.
• Jared Charles Rosenberg, D.C.
• Michael J. Rosenblatt, M.D.
• Harold Myron Rosenthal, M.D.
• Daniel Sloan Rospert, MD

• Sleep Specialist (PhD) in Webster, TX
• Providers in Webster, TX by specialty
• Sleep Specialist (PhD) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.