Healthcare Provider Details

I. General information

NPI: 1386557429
Provider Name (Legal Business Name): JOEL CRAIG ROGERS BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 S INTERSTATE 35 E
DENTON TX
76205-7768
US

IV. Provider business mailing address

PO BOX 99335
FORT WORTH TX
76199-0335
US

V. Phone/Fax

Practice location:
  • Phone: 940-369-5373
  • Fax: 940-800-2862
Mailing address:
  • Phone: 940-369-5373
  • Fax: 940-800-2862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBHV010919
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: