Individual
DR. ROGER A. BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0387
(468) 522-6889
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0387
(468) 522-6889
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D4023
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121715004
—
TX
05
—
121715008
—
TX
05
—
139726709
—
TX
05
—
285250104
—
TX
Enumeration date
06/02/2006
Last updated
02/19/2014
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