Provider Demographics
NPI:1801805239
Name:ROUSSEAU, DENNIS L JR (MD/ PHD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:L
Last Name:ROUSSEAU
Suffix:JR
Gender:M
Credentials:MD/ PHD
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Mailing Address - Street 1:8715 VILLAGE DR
Mailing Address - Street 2:SUITE 620
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5405
Mailing Address - Country:US
Mailing Address - Phone:210-946-1400
Mailing Address - Fax:210-946-1616
Practice Address - Street 1:8715 VILLAGE DR
Practice Address - Street 2:SUITE 620
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5405
Practice Address - Country:US
Practice Address - Phone:210-946-1400
Practice Address - Fax:210-946-1616
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2012-12-18
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Provider Licenses
StateLicense IDTaxonomies
TXL05542086X0206X
FLME 993582086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology