Healthcare Provider Details

I. General information

NPI: 1285652453
Provider Name (Legal Business Name): ROBERT W ROMERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 W CONGRESS ST STE 2300
LAFAYETTE LA
70506-6765
US

IV. Provider business mailing address

PO BOX 53709
LAFAYETTE LA
70505-3709
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-7546
  • Fax: 337-988-2037
Mailing address:
  • Phone: 337-981-7546
  • Fax: 337-988-2037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number011162
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: