Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 49674 | CO |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 49674 | CO |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A111830 | CA |
NPI | 1124220595 |
---|---|
Provider Name | Dr. Alex Anthony Romero |
First Address | Pueblo, CO 81008-1667 |
Second Address | Pueblo, CO 81008-1667 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 16/08/2011 |