Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | A148793 | CA |
Y | 207PE0004X | Emergency Medical Services | S2486 | TX |
NPI | 1104264316 |
---|---|
Provider Name | Matthew Thomas Rogers |
First Address | Houston, TX 77006-4330 |
Second Address | Houston, TX 77089-6041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 29/06/2019 |