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General NPI Number Information
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NPI Number | 1588611636
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Entity Type | Organization
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Legal Business Name | ROGER M. TRAXEL, M.D.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 2012 W OHIO AVE
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City | MIDLAND
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State | TX
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Zip | 79701-5946
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Country | US
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Telephone | 432-683-1856
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Fax | 432-683-7597
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Provider Business Mailing Address
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Address Line | 2012 W. OHIO
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City | MIDLAND
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State | TX
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Zip | 79701
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Country | US
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Telephone | 432-683-1856
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Fax | 432-683-7597
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ROGER MARTIN TRAXEL
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Credential | M.D.
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Telephone | 432-683-1856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | E9443
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License Number State | TX
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