Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | J3711 | TX |
NPI | 1255413779 |
---|---|
Provider Name | Dr. Michael J Romano |
First Address | El Paso, TX 79995-9520 |
Second Address | El Paso, TX 79905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 29/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1840025000 | (05) | WV |
F55130 | (02) |