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Individual

ROGER G BUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7808 CLODUS FIELDS DR, DALLAS, TX 75251-2206
(972) 566-7260
(972) 566-6237
Mailing address
7808 CLODUS FIELDS DR, DALLAS, TX 75251-2206
(972) 770-1032
(972) 770-1032

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
34096
TX
2084P0800X
Psychiatry Physician
Primary
G9839
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122603702
TX
05
122603705
TX
Enumeration date
11/16/2005
Last updated
02/10/2022
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