Provider Demographics
NPI:1396065470
Name:ROGERS, RYAN T (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:T
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4444 CORONA DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4324
Mailing Address - Country:US
Mailing Address - Phone:361-985-1221
Mailing Address - Fax:361-992-1667
Practice Address - Street 1:14650 COMPASS ST STE 1
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-6237
Practice Address - Country:US
Practice Address - Phone:361-867-1032
Practice Address - Fax:361-867-1018
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2023-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXQ6096207N00000X, 207ND0101X, 207ND0101X
SC85301207N00000X
GA71625207ND0101X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology