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General NPI Number Information
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NPI Number | 1750562237
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Entity Type | Organization
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Legal Business Name | ANTONIO ROMAN, MD, PA
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 6116 N CENTRAL EXPY SUITE 915
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City | DALLAS
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State | TX
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Zip | 75206-5162
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Country | US
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Telephone | 214-969-2953
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Fax | 214-363-2899
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Provider Business Mailing Address
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Address Line | 110 W SANDY LAKE RD STE 102
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City | COPPELL
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State | TX
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Zip | 75019-2529
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Country | US
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Telephone | 972-315-5249
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTONIO ROMAN
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Credential | MD
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Telephone | 214-969-2953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | J7286
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License Number State | TX
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