Provider Demographics
NPI:1487646667
Name:RODGERS, GEORGE P (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:P
Last Name:RODGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N IH 35
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1926
Mailing Address - Country:US
Mailing Address - Phone:512-324-8300
Mailing Address - Fax:512-324-8301
Practice Address - Street 1:6811 AUSTIN CENTER BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3146
Practice Address - Country:US
Practice Address - Phone:512-324-2705
Practice Address - Fax:512-324-2706
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG5548207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134200815Medicaid
TX8ET556OtherBCBS
TX134200812Medicaid
TX134200813Medicaid
TX134200814Medicaid
TX8CR656OtherBCBS
TXTXB164471Medicare PIN
TXTXB121366Medicare PIN
TX134200814Medicaid
TX329612YL9XMedicare PIN
TX8CR656OtherBCBS