Healthcare Provider Details

I. General information

NPI: 1053550178
Provider Name (Legal Business Name): LUIS CARLOS MAYOR ROMERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LUIS CARLOS MAYOR

II. Dates (important events)

Enumeration Date: 02/12/2009
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-2952
  • Fax: 319-356-4505
Mailing address:
  • Phone: 319-356-2952
  • Fax: 319-356-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberSP-0319
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberSP-0319
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberSP-0319
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: