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General NPI Number Information
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NPI Number | 1992889661
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Entity Type | Individual
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Provider Name | JOHN T ROGERS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 04/14/2016
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Provider Practice Location Address
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Address Line | 3200 RIVERFRONT DR STE 103
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City | FORT WORTH
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State | TX
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Zip | 76107-6570
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Country | US
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Telephone | 817-336-3800
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Fax | 817-335-9454
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Provider Business Mailing Address
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Address Line | PO BOX 99371
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City | FORT WORTH
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State | TX
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Zip | 76199-0371
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Country | US
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Telephone | 682-885-1855
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Fax | 682-885-7347
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C8425
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License Number State | TX
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