Provider Demographics
NPI:1700885324
Name:MUSE, ROGER K (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:K
Last Name:MUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 MCCULLOUGH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4813
Mailing Address - Country:US
Mailing Address - Phone:210-271-3204
Mailing Address - Fax:210-222-2761
Practice Address - Street 1:1100 MCCULLOUGH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4813
Practice Address - Country:US
Practice Address - Phone:210-271-3204
Practice Address - Fax:210-222-2761
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3802207RC0000X, 207RC0001X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84857GOtherBCBS
TX8CU332OtherBCBS
TX037391204Medicaid
TX060049005OtherRAILROAD MEDICARE
TXP00948207OtherRAILROAD
TX060049005OtherRAILROAD MEDICARE
TX80623JMedicare ID - Type Unspecified
TX8CU332OtherBCBS
TX037391204Medicaid
TX060049005OtherRAILROAD MEDICARE
TX84857GOtherBCBS
TX80623JMedicare ID - Type Unspecified