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Individual

ROGER RODENHUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
SL57 LAKE CHEROKEE, HENDERSON, TX 75652
(817) 516-8811
(817) 516-8444
Mailing address
PO BOX 7909, LONGVIEW, TX 75607-7909
(817) 516-8811
(817) 516-8444

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J9308
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
264322700
FL
01
29047
BLUE CROSS BLUE SHIELD
FL
01
P00053082
RAILROAD MEDICARE
DC
Enumeration date
10/02/2006
Last updated
10/03/2018
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