MEDICARE: DR. LYDIA NAVARRO ROMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	G5826	TX

General Provider Information

NPI Number	:	1003889635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYDIA NAVARRO ROMAN M.D.

Provider Business Mailing Address
First Line	:	5815 GULF FWY STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-5362
Country	:	US
Telephone Number	:	713-643-0012
Fax Number	:	713-643-5808

Provider Business Practice Location Address
First Line	:	5815 GULF FWY STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-5362
Country	:	US
Telephone Number	:	713-643-0012
Fax Number	:	713-643-5808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	02/10/2023

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