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General NPI Number Information
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NPI Number | 1295953156
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Entity Type | Organization
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Legal Business Name | GERALD W ROGERS M.A.,M.S.W.,PHD,P.A.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7480 GOLDEN POND SUITE 400
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City | AMARILLO
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State | TX
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Zip | 79121
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Country | US
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Telephone | 806-354-9996
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Fax | 806-354-9995
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Provider Business Mailing Address
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Address Line | PO BOX 50660
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City | AMARILLO
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State | TX
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Zip | 79159-0660
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Country | US
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Telephone | 806-354-9996
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Fax | 806-354-9995
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | DR. GERALD WAYNE ROGERS
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Credential | PHD, P.A.
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Telephone | 806-354-9996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | TX
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