Provider Demographics
NPI:1801806104
Name:ROGLER, GINENE (M D)
Entity type:Individual
Prefix:
First Name:GINENE
Middle Name:
Last Name:ROGLER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7784 WISHING WELL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2072
Mailing Address - Country:US
Mailing Address - Phone:702-544-7505
Mailing Address - Fax:702-544-7505
Practice Address - Street 1:7784 WISHING WELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2072
Practice Address - Country:US
Practice Address - Phone:702-544-7505
Practice Address - Fax:702-837-6994
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0550207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151279001Medicaid
NV1801806104Medicaid
NVCT318YMedicare PIN
NV1801806104Medicaid