Provider Demographics
NPI:1427735810
Name:AMBER ROGERS, MD, PLLC
Entity type:Organization
Organization Name:AMBER ROGERS, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:682-367-0703
Mailing Address - Street 1:928 LIPSCOMB ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3171
Mailing Address - Country:US
Mailing Address - Phone:682-367-0703
Mailing Address - Fax:682-990-2594
Practice Address - Street 1:928 LIPSCOMB ST STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3171
Practice Address - Country:US
Practice Address - Phone:682-367-0703
Practice Address - Fax:682-990-2594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty