Provider Demographics
NPI:1174846661
Name:ROMANO, MELISSA (RD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:OLIVAREZ
Other - Last Name:ROMANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:7381 LA CASA WAY
Mailing Address - Street 2:
Mailing Address - City:CANUTILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79835-6105
Mailing Address - Country:US
Mailing Address - Phone:915-309-3745
Mailing Address - Fax:
Practice Address - Street 1:7381 LA CASA WAY
Practice Address - Street 2:
Practice Address - City:CANUTILLO
Practice Address - State:TX
Practice Address - Zip Code:79835-6105
Practice Address - Country:US
Practice Address - Phone:915-309-3745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06903133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered