Rodgers, Randall W

Rodgers, Randall W is an individual health care provider with primary practice located at 13027 State Highway 155 S , Tyler TX 75703-6560. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Rodgers, Randall W can be contacted via phone (903) 839-1000.

Contact Information

Primary practice address
13027 State Highway 155 S Tyler TX 75703-6560
Phone: (903) 839-1000
Fax: (903) 839-4000
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G0020 Texas
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X G0020 Texas

Profile Details

NPI number 1104852888
LBN Legal business name Rodgers, Randall W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2006
Last updated Apr 30th, 2026 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104852888 NPPES
Texas Other 8V0490 BCBSTX
Texas Other P00342603 BCBSTX
Texas Other 43848 BCBSTX
Texas Other 1104852888 BCBSTX
Texas MEDICAID 1287773-08 BCBSTX
Texas Other 663166 BCBSTX

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