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General NPI Number Information
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NPI Number | 1619970969
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Entity Type | Individual
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Provider Name | ROBERT J. ROGERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 4200 S HULEN ST STE 230
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City | FORT WORTH
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State | TX
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Zip | 76109-4924
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Country | US
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Telephone | 817-315-2550
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Fax | 817-732-4660
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Provider Business Mailing Address
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Address Line | 4200 S HULEN ST STE 230
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City | FORT WORTH
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State | TX
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Zip | 76109-4924
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Country | US
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Telephone | 817-315-2550
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Fax | 817-732-4660
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | F4444
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number | F4444
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | F4444
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License Number State | TX
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