Provider Demographics
NPI:1932504156
Name:ROSS A BOGEY DO
Entity Type:Organization
Organization Name:ROSS A BOGEY DO
Other - Org Name:ROSS A BOGEY DO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BOGEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:312-415-9368
Mailing Address - Street 1:101 JAMES COLEMAN DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3100
Mailing Address - Country:US
Mailing Address - Phone:361-894-7930
Mailing Address - Fax:361-894-7929
Practice Address - Street 1:101 JAMES COLEMAN DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3100
Practice Address - Country:US
Practice Address - Phone:361-894-7930
Practice Address - Fax:361-894-7929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0990283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL0990OtherLICENSE
TXG69465OtherUPIN