Healthcare Provider Details

I. General information

NPI: 1548660632
Provider Name (Legal Business Name): JESSICA ANNE ROMERO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA ANNE RAMIREZ PA-C

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 MONTANA AVE STE B
EL PASO TX
79903-4909
US

IV. Provider business mailing address

PO BOX 360557
PITTSBURGH PA
15251-6557
US

V. Phone/Fax

Practice location:
  • Phone: 915-444-5460
  • Fax:
Mailing address:
  • Phone: 915-533-7057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA09385
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: