Provider Demographics
NPI:1972574150
Name:ROGERS, STEVEN RAY (RPH)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:RAY
Last Name:ROGERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 NORTHFIELD CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-4439
Mailing Address - Country:US
Mailing Address - Phone:432-694-0794
Mailing Address - Fax:
Practice Address - Street 1:3510 N. MIDKIFF RD.
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705
Practice Address - Country:US
Practice Address - Phone:432-697-7500
Practice Address - Fax:432-697-7507
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist