Healthcare Provider Details

I. General information

NPI: 1154148716
Provider Name (Legal Business Name): DYLAN ALBERTO ROMERO JIMENEZ CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28550 HEMPSTEAD RD
CYPRESS TX
77433-4288
US

IV. Provider business mailing address

7432 PARKLAND MANOR DR
CYPRESS TX
77433-3246
US

V. Phone/Fax

Practice location:
  • Phone: 281-256-6490
  • Fax:
Mailing address:
  • Phone: 832-873-2387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number322325
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: