Individual
DR. NICOLE LYNN ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3901 W 15TH ST, PLANO, TX 75075-7738
(972) 758-3598
Mailing address
PO BOX 201606, DALLAS, TX 75320-1606
(972) 758-3598
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K7556
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029711102
—
TX
05
—
029711103
—
TX
05
—
029711104
—
TX
01
—
8F4447
BCBS
TX
01
—
930125954
MEDICARE RAILROAD
TX
01
—
930128385
MEDICARE RAILROAD
TX
Enumeration date
12/16/2005
Last updated
08/29/2011
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