Healthcare Provider Details

I. General information

NPI: 1457361925
Provider Name (Legal Business Name): WILLIAM ROGERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N SANTA ROSA ST
SAN ANTONIO TX
78207-3108
US

IV. Provider business mailing address

315 N SAN SABA SUITE 1003
SAN ANTONIO TX
78207-3154
US

V. Phone/Fax

Practice location:
  • Phone: 210-704-4038
  • Fax: 210-704-4520
Mailing address:
  • Phone: 210-704-4038
  • Fax: 210-704-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberJ1375
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: