Basic Information
| Provider Information | |||||||||
| NPI: | 1720086382 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SESSIONS | ||||||||
| FirstName: | ROGER | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 612 N HIGH ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | HENDERSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756525914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9036571441 | ||||||||
| FaxNumber: | 9036551442 | ||||||||
| Practice Location | |||||||||
| Address1: | 612 N HIGH ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | HENDERSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756525914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9036571441 | ||||||||
| FaxNumber: | 9036551442 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2005 | ||||||||
| LastUpdateDate: | 04/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G5595 | TX | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | AS2945218 | 01 | TX | DEA | OTHER | 110544703 | 05 | TX | MEDICAID | 200025040 | 01 | TX | RR MCR | OTHER | C8386 | 01 | TX | RR MCR GROUP | OTHER | 00476Z | 01 | TX | MCR GROUP | OTHER | 2226360 | 01 | TX | BCBS BLUE LINK | OTHER | 0857690-01 | 01 | TX | MCD GROUP | OTHER |