Healthcare Provider Details

I. General information

NPI: 1942217765
Provider Name (Legal Business Name): ERNEST T ROMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 FM 2920 RD STE 205
SPRING TX
77379-3474
US

IV. Provider business mailing address

6225 FM 2920 RD STE 205
SPRING TX
77379-3474
US

V. Phone/Fax

Practice location:
  • Phone: 832-559-3061
  • Fax: 832-559-3783
Mailing address:
  • Phone: 832-559-3061
  • Fax: 832-559-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberH6938
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: