Provider Demographics
NPI:1225037559
Name:RODGERS, HAROLD LYNN JR (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:LYNN
Last Name:RODGERS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 RAINTREE CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-4900
Mailing Address - Country:US
Mailing Address - Phone:972-727-9995
Mailing Address - Fax:972-727-8350
Practice Address - Street 1:1125 RAINTREE CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4900
Practice Address - Country:US
Practice Address - Phone:972-727-9995
Practice Address - Fax:972-727-8350
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6001207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00913329OtherMEDICARE RAILROAD - EFFECT 02/01/2011
HH011AOtherBCBS
TXTXB117535OtherMEDICARE PART B - EFFECT. 02/01/2011
TX8CR168OtherBC/BS TX - EFFECT. 02/01/2011
TX6484850004Medicare NSC
TXTXB117535OtherMEDICARE PART B - EFFECT. 02/01/2011
HH011AOtherBCBS
TX6484850001Medicare NSC