Healthcare Provider Details

I. General information

NPI: 1154286581
Provider Name (Legal Business Name): DANIEL ROMO FUENTES LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 ANDREWS HWY
MIDLAND TX
79703-4963
US

IV. Provider business mailing address

3701 ANDREWS HWY
MIDLAND TX
79703-4963
US

V. Phone/Fax

Practice location:
  • Phone: 432-570-1084
  • Fax: 432-570-4069
Mailing address:
  • Phone: 432-570-1084
  • Fax: 432-570-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number94479
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: