Provider Demographics
NPI:1881211910
Name:ROGERS, ASHTON A'LIZABETH (MED, LAT, ATC, CST)
Entity Type:Individual
Prefix:MRS
First Name:ASHTON
Middle Name:A'LIZABETH
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MED, LAT, ATC, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-0223
Mailing Address - Country:US
Mailing Address - Phone:979-236-9390
Mailing Address - Fax:
Practice Address - Street 1:639 CR 642
Practice Address - Street 2:
Practice Address - City:YANCEY
Practice Address - State:TX
Practice Address - Zip Code:78886-7888
Practice Address - Country:US
Practice Address - Phone:979-373-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT49532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer