Provider Demographics
NPI:1578755070
Name:JOE, ROGER G (MD, MBA)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:G
Last Name:JOE
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 S 9TH ST STE 118
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3448
Mailing Address - Country:US
Mailing Address - Phone:281-201-2571
Mailing Address - Fax:832-532-7915
Practice Address - Street 1:301 S 9TH ST STE 118
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3448
Practice Address - Country:US
Practice Address - Phone:281-451-6508
Practice Address - Fax:832-471-6972
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ434682084P0800X
TXP43222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry