Provider Demographics
NPI:1235393307
Name:ROGENE, LLC
Entity Type:Organization
Organization Name:ROGENE, LLC
Other - Org Name:PARMER LANE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-339-6635
Mailing Address - Street 1:2121 W PARMER LN
Mailing Address - Street 2:112
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-4300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2121 W PARMER LN
Practice Address - Street 2:112
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-4300
Practice Address - Country:US
Practice Address - Phone:512-339-6635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty