Provider Demographics
NPI:1134503543
Name:ROGET, MICHAL
Entity type:Individual
Prefix:MRS
First Name:MICHAL
Middle Name:
Last Name:ROGET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6512 OPUS DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5810
Mailing Address - Country:US
Mailing Address - Phone:469-766-9126
Mailing Address - Fax:
Practice Address - Street 1:6512 OPUS DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5810
Practice Address - Country:US
Practice Address - Phone:469-766-9126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16767235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347970101Medicaid
TX83S140OtherBLUE CROSS BLUE SHIELD