Provider Demographics
NPI:1043773187
Name:ROSIGNOLI, LUCA (MD)
Entity type:Individual
Prefix:DR
First Name:LUCA
Middle Name:
Last Name:ROSIGNOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUCA
Other - Middle Name:MARIO
Other - Last Name:ROSIGNOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1512 W 35TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-1437
Mailing Address - Country:US
Mailing Address - Phone:512-451-0103
Mailing Address - Fax:512-454-2741
Practice Address - Street 1:801 W 38TH ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1169
Practice Address - Country:US
Practice Address - Phone:512-451-0103
Practice Address - Fax:512-451-2741
Is Sole Proprietor?:No
Enumeration Date:2019-04-06
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV0140207W00000X
OK40917207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology