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NPI Code Detail

MEDICARE: DR. BRENT ROCKE M.D.

MEDICARE:  DR. BRENT  ROCKE  M.D.
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
1207W00000XOphthalmology PhysicianQ1008TX
2207W00000XOphthalmology Physician4301109051MI
3207WX0107XRetina Specialist (Ophthalmology) Physician4301109051MI

General Provider Information

NPI Number : 1699902346
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENT ROCKE M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 254-724-2111
Fax Number :
Provider Business Practice Location Address
First Line : 1815 S 31ST ST
Second Line :
City : TEMPLE
State : TX
Zip : 76504-6728
Country : US
Telephone Number : 254-724-2111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2009
Last Update Date : 12/29/2021

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Directions to “ DR. BRENT ROCKE M.D.” Practice Location

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