Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 13241 | TX |
N | 111NP0017X | Pediatric Chiropractor | 13241 | TX |
NPI | 1184169351 |
---|---|
Provider Name | Dr. Jacqueline Ann Romanies |
First Address | Plano, TX 75093-5619 |
Second Address | Plano, TX 75093-5619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2016 |
Last Update Date | 27/12/2016 |