MEDICARE: JAVIER ROMAN-GONZALEZ 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	207RC0001X	Clinical Cardiac Electrophysiology Physician	J9310	TX
2	207RC0000X	Cardiovascular Disease Physician	J9310	TX

General Provider Information

NPI Number	:	1427058643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAVIER ROMAN-GONZALEZ M.D.

Provider Business Mailing Address
First Line	:	6800 W IH 10
Second Line	:	SUITE 350
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-2038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 W IH 10
Second Line	:	SUITE 350
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-2038
Country	:	US
Telephone Number	:	210-615-0494
Fax Number	:

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	02/09/2022

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