Provider Demographics
NPI:1659462042
Name:ROGERS CLINIC OF CHIROPRACTIC REHABILITATION PLLC
Entity Type:Organization
Organization Name:ROGERS CLINIC OF CHIROPRACTIC REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-691-2266
Mailing Address - Street 1:12820 HILLCREST RD # C306
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1526
Mailing Address - Country:US
Mailing Address - Phone:214-691-2266
Mailing Address - Fax:214-691-2266
Practice Address - Street 1:12820 HILLCREST RD STE C205
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1526
Practice Address - Country:US
Practice Address - Phone:214-691-2266
Practice Address - Fax:214-691-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9201111N00000X
TX1114247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G4310OtherBCBS