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General NPI Number Information
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NPI Number | 1255114955
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Entity Type | Individual
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Provider Name | ANISSA ROMO PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 500 W 4TH ST
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City | ODESSA
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State | TX
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Zip | 79761-5001
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Country | US
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Telephone | 432-620-2401
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Fax | 432-640-4778
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Provider Business Mailing Address
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Address Line | PO BOX 2129
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City | ODESSA
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State | TX
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Zip | 79760-2129
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Country | US
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Telephone | 432-640-2401
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Fax | 432-640-4778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA19557
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License Number State | TX
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