Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 32056 | TX |
NPI | 1043706161 |
---|---|
Provider Name | Dr. Anika Sarah Rodgers |
First Address | Manvel, TX 77578-3574 |
Second Address | Houston, TX 77030-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2018 |
Last Update Date | 02/07/2018 |