MEDICARE: DONZA JENAI ROGERS MD

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
1	208000000X	Pediatrics Physician	M4482	TX

General Provider Information

NPI Number	:	1760562797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONZA JENAI ROGERS MD

Provider Business Mailing Address
First Line	:	3523 MCKINNEY AVE # 263
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-1401
Country	:	US
Telephone Number	:	214-912-1581
Fax Number	:	214-520-7120

Provider Business Practice Location Address
First Line	:	3523 MCKINNEY AVE # 263
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-1401
Country	:	US
Telephone Number	:	214-912-1581
Fax Number	:	214-520-7120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	12/24/2007

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