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NPI Profile for ADELINE MEMORIAL MEDICAL GROUP PLLC in ROSENBERG, TX.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Pediatrics |
208000000X | 37 | Physician/Pediatric Medicine |
| NPI Number | 1760075667 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/11/2021 | |
| Last updated | 08/06/2025 - About 10 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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ADELINE MEMORIAL MEDICAL GROUP PLLC