Organization
ROGER J. WOLCOTT, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET W BEYER (OFFICE MANAGER)
(806) 797-2139
Entity
Organization
Contact information
Practice address
5902 66TH ST UNIT B, LUBBOCK, TX 79424-5933
(806) 797-2139
(806) 797-3105
Mailing address
5902 66TH ST UNIT B, LUBBOCK, TX 79424-5933
(806) 797-2139
(806) 797-3105
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J4620
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028AA
BLUE CROSS BLUE SHIELD
TX
05
—
110687404
—
TX
05
—
172052601
—
TX
Enumeration date
11/13/2007
Last updated
02/21/2022
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