Provider Demographics
NPI:1265611065
Name:ROOKER, KEVIN T (RDMS, RVT)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:T
Last Name:ROOKER
Suffix:
Gender:M
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2921 BROWN TRL
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4144
Mailing Address - Country:US
Mailing Address - Phone:817-849-8700
Mailing Address - Fax:817-849-8701
Practice Address - Street 1:2921 BROWN TRL
Practice Address - Street 2:SUITE 150
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4144
Practice Address - Country:US
Practice Address - Phone:817-849-8700
Practice Address - Fax:817-849-8701
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
124702471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4241HMOtherBLUE CROSS/BLUE SHIELD
TXFTCVU8Medicare PIN