Individual
DR. RANDALL W RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
13027 STATE HIGHWAY 155 S, TYLER, TX 75703-6560
(903) 839-1000
(903) 839-4000
Mailing address
13027 STATE HIGHWAY 155 S, TYLER, TX 75703-6560
(903) 839-1000
(903) 839-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G0020
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
G0020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104852888
BCBSTX
TX
05
—
1287773-08
—
TX
01
—
43848
STERLING
TX
01
—
663166
STERLING MEDICARE ADVANTAGE
TX
01
—
8V0490
BCBSTX
TX
01
—
P00342603
RAILROAD MEDICARE
TX
Enumeration date
06/24/2006
Last updated
04/30/2026
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