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NPI Code Detail

MEDICARE: ROGER G BUTLER MD

MEDICARE: ROGER G BUTLER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist34096TX
22084P0800XPsychiatry PhysicianG9839TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538141528
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER G BUTLER MD
Provider Business Mailing Address
First Line : 7808 CLODUS FIELDS DR
Second Line :
City : DALLAS
State : TX
Zip : 75251-2206
Country : US
Telephone Number : 972-770-1032
Fax Number : 972-770-1032
Provider Business Practice Location Address
First Line : 7808 CLODUS FIELDS DR
Second Line :
City : DALLAS
State : TX
Zip : 75251-2206
Country : US
Telephone Number : 972-566-7260
Fax Number : 972-566-6237
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 02/10/2022

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