Individual
CLAYTON ROSS ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1401 W PULASKI ST, FORT WORTH, TX 76104-2717
(682) 885-8012
(682) 885-8014
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-1860
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP136399
TX
363LF0000X
Family Nurse Practitioner
Primary
AP136399
TX
363LP0200X
Pediatric Nurse Practitioner
844877
TX
Other
Enumeration date
12/12/2017
Last updated
04/20/2021
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