Provider Demographics
NPI:1770052136
Name:BRIAN ROGERS, DO
Entity type:Organization
Organization Name:BRIAN ROGERS, DO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-934-7828
Mailing Address - Street 1:9 MEDICAL PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7868
Mailing Address - Country:US
Mailing Address - Phone:214-382-9894
Mailing Address - Fax:817-887-5042
Practice Address - Street 1:809 W HARWOOD RD STE 202
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-6233
Practice Address - Country:US
Practice Address - Phone:817-369-3019
Practice Address - Fax:817-887-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty