Provider Demographics
NPI:1154833366
Name:VOGT, JENNIFER RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:RENEE
Last Name:VOGT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 AUGUSTA LN
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-8430
Mailing Address - Country:US
Mailing Address - Phone:337-208-3982
Mailing Address - Fax:
Practice Address - Street 1:4301 SATURN RD STE 201
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5351
Practice Address - Country:US
Practice Address - Phone:214-275-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor