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General NPI Number Information
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NPI Number | 1902112956
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Entity Type | Organization
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Legal Business Name | ROMERO FAMILY MEDICINE,LLC
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 4600 JEFFERSON LN NE SUITE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2134
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Country | US
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Telephone | 505-924-1895
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Fax | 505-792-1890
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Provider Business Mailing Address
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Address Line | 4600 JEFFERSON LN NE STE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2134
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Country | US
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Telephone | 505-881-1229
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Fax | 55-888-1918
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANGELA LIZA ROMERO
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Credential | M.D.
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Telephone | 505-924-1895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 03195795001
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License Number State | NM
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