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DR. JACKIE ROSE MD
NPI 1073552691
Emergency Medicine in Tyler, TX

Active since June 06, 2006
1000 S BECKHAM AVE, TYLER, TX 75701(903) 597-0351(903) 592-5282 Get Directions Write a Review

NPPES record last updated: November 2, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jackie Rose Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACKIE ROSE MD (NPI 1073552691) is an individual emergency medicine provider in Tyler, Texas, licensed in Texas (H2738) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1073552691
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. JACKIE ROSECredential: MD
Location Address1000 S BECKHAM AVETyler, TX 75701-1908
Mailing AddressPo Box 6455Tyler, TX 75711-6455 · (903) 594-2451 · Fax (903) 509-0493
Phone(903) 597-0351
Fax(903) 592-5282
Sole ProprietorNo
Enumeration DateJune 6, 2006
Last NPPES UpdateNovember 2, 2007
✔ NPI 1073552691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in TX · H2738
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
1000 S BECKHAM AVE, Tyler, TX 75701
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Other Identifiers 2

Medicare PIN8839B6TX
Medicare UPINE20041TX

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MUHAMMAD KAFEEL SARWAR M.D.
Internal Medicine
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 590-5611
JOHN GLYNN JEANSONNE CRNA
Nurse Anesthetist, Certified Registered
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 526-1068
ARAMISH SAEED KHAN
Student in an Organized Health Care Education/Training Program
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 594-2269
DR. FARZAD FAKOURI M.D. , MPH
Internal Medicine
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 590-5611
ARNULFO DUARTE DO
Internal Medicine
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 590-5611
HAROLD RICHIE BANDALAN CRNA
Nurse Anesthetist, Certified Registered
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 526-1068
TYLER REGIONAL HOSPITAL LLC
Surgery (Trauma Surgery)
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 597-0351
ALEX DETWILER, M.D., P.A.
Specialist
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 521-7838

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackie Rose's NPI number?

The NPI number for Jackie Rose is 1073552691. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Where is Jackie Rose located?

Jackie Rose practices at 1000 S Beckham Ave, Tyler, TX 75701. The listed phone number is (903) 597-0351.

What is Jackie Rose's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

When was this NPI record last updated?

The NPPES record for Jackie Rose was last updated on November 2, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.