Provider Demographics
NPI:1447541545
Name:AN, RUOSU (MD)
Entity type:Individual
Prefix:
First Name:RUOSU
Middle Name:
Last Name:AN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 LAKEVIEW PKWY
Mailing Address - Street 2:STE C
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7700 LAKEVIEW PKWY
Practice Address - Street 2:STE C
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4302
Practice Address - Country:US
Practice Address - Phone:972-487-7928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR390200000X2086S0129X
TXQ80062086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery