Provider Demographics
NPI:1407266844
Name:MARK R ROGERS MD PA
Entity Type:Organization
Organization Name:MARK R ROGERS MD PA
Other - Org Name:WEST HOUSTON ORTHOPEDIC AND SPORTS MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-497-9993
Mailing Address - Street 1:12000 RICHMOND AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2964
Mailing Address - Country:US
Mailing Address - Phone:281-497-9993
Mailing Address - Fax:281-497-9991
Practice Address - Street 1:12000 RICHMOND AVE STE 370
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2964
Practice Address - Country:US
Practice Address - Phone:281-497-9993
Practice Address - Fax:281-497-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0770207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467453423OtherTYPE 1 NPI
TX125224905Medicaid
B07173Medicare UPIN