Provider Demographics
NPI:1356453443
Name:ROGERS, CHERYL JAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:JAN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6769 ISLA DEL REY DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7336
Mailing Address - Country:US
Mailing Address - Phone:915-584-4762
Mailing Address - Fax:
Practice Address - Street 1:6769 ISLA DEL REY DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-7336
Practice Address - Country:US
Practice Address - Phone:915-584-4762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG 7711207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine