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NPI Code Detail

MEDICARE: MRS. LYNN RODGERS

MEDICARE: MRS. LYNN RODGERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor71781TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285284661
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNN RODGERS
Provider Business Mailing Address
First Line : 2010 AL LIPSCOMB WAY
Second Line :
City : DALLAS
State : TX
Zip : 75215-2773
Country : US
Telephone Number : 214-421-6705
Fax Number : 214-421-0484
Provider Business Practice Location Address
First Line : 2010 AL LIPSCOMB WAY
Second Line :
City : DALLAS
State : TX
Zip : 75215-2773
Country : US
Telephone Number : 214-421-6705
Fax Number : 214-421-0484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2019
Last Update Date : 09/17/2019

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