Most Relevant Information
Provider Data
| NPI Number: | 1003298050 |
| Provider Name: | TIFFANY ANN ROSE PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA09855 |
Most Important Dates
| Enumeration Date: | 06/26/2015 |
| Last Updated: | 12/23/2021 |
Provider Practice Location
120 HILLCREST MEDICAL BLVD STE 200
WACO
TX
767128950
Practice Location Phone/Fax
| Phone: | 2542970400 |
| Fax: |
Provider Mailing Location
PO BOX 844658
DALLAS
TX
752844658
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |