Healthcare Provider Details

I. General information

NPI: 1659381663
Provider Name (Legal Business Name): DORA D ROGERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: D DEBRA ROGERS MD

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N SAN SABA STE 1180
SAN ANTONIO TX
78207-3154
US

IV. Provider business mailing address

PO BOX 701306
SAN ANTONIO TX
78270-1306
US

V. Phone/Fax

Practice location:
  • Phone: 210-270-7800
  • Fax: 210-270-7803
Mailing address:
  • Phone: 210-270-7800
  • Fax: 210-270-7803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberJ4485
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: