Provider Demographics
NPI:1235744822
Name:ROGERS, ZACHARY (CC-SLP)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:
Last Name:ROGERS
Suffix:
Gender:M
Credentials:CC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 PAIGE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-3231
Mailing Address - Country:US
Mailing Address - Phone:512-940-9660
Mailing Address - Fax:
Practice Address - Street 1:901 W BAKER RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2398
Practice Address - Country:US
Practice Address - Phone:512-940-9660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24943235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist