Provider Demographics
NPI:1235526864
Name:DR. ROGERS WEIGHTLOSS CENTERS PA
Entity Type:Organization
Organization Name:DR. ROGERS WEIGHTLOSS CENTERS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMYRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-495-2117
Mailing Address - Street 1:2815 N LOOP 1604 E
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1708
Mailing Address - Country:US
Mailing Address - Phone:210-495-2117
Mailing Address - Fax:888-893-4363
Practice Address - Street 1:2815 N LOOP 1604 E
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1708
Practice Address - Country:US
Practice Address - Phone:210-495-2117
Practice Address - Fax:888-893-4363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3099207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Single Specialty