Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5750TG | TX |
NPI | 1003888942 |
---|---|
Provider Name | Dr. Joseph R Rogalinski |
First Address | San Antonio, TX 78249-2898 |
Second Address | San Antonio, TX 78249-2898 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2006 |
Last Update Date | 14/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
175784101 | (05) | TX |