Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | S8109 | TX |
NPI | 1285051557 |
---|---|
Provider Name | Kameron Parker Lockamy Rogers |
First Address | Lubbock, TX 79407-3545 |
Second Address | Lubbock, TX 79415-3364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2014 |
Last Update Date | 25/03/2021 |