Organization
CAREFIRST MEDICAL ASSOCIATES AND PAIN REHABILITATION, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL W RODGERS D.O. (PHYSICIAN-PRESIDENT)
(903) 839-1000
Entity
Organization
Contact information
Practice address
13027 STATE HIGHWAY 155 S, TYLER, TX 75703-6548
(903) 839-1000
(903) 839-4000
Mailing address
13027 STATE HIGHWAY 155 S, TYLER, TX 75703-6548
(903) 839-1000
(903) 839-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076NH
BCBS
TX
01
—
1114953767
BCBSTX
TX
01
—
DF1536
RAILROAD MEDICARE
TX
Enumeration date
06/24/2006
Last updated
08/16/2016
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