Provider Demographics
NPI:1265026462
Name:ROGERS, MATTHEW LEE JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:LEE
Last Name:ROGERS
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 S POST OAK RD STE E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-2021
Mailing Address - Country:US
Mailing Address - Phone:713-545-0748
Mailing Address - Fax:
Practice Address - Street 1:3702 S VIRKUS CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6934
Practice Address - Country:US
Practice Address - Phone:713-545-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-28
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist