Individual
MRS. SUSAN V RODGERS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1919 S LOOP 256, PALESTINE, TX 75801-5915
(903) 723-2880
(903) 723-1910
Mailing address
1919 S LOOP 256, PALESTINE, TX 75801-5915
(903) 723-2880
(903) 723-1910
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
104627
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090101208374375
PTCB #
TX
01
—
104627
STATE PHARMACY TECH. #
TX
Enumeration date
07/19/2005
Last updated
07/08/2007
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