Provider Demographics
NPI:1205861911
Name:ROMAN, ROCIO L (MD)
Entity Type:Individual
Prefix:
First Name:ROCIO
Middle Name:L
Last Name:ROMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 KELLEY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-1818
Mailing Address - Country:US
Mailing Address - Phone:713-218-2697
Mailing Address - Fax:
Practice Address - Street 1:5550 KELLEY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-1818
Practice Address - Country:US
Practice Address - Phone:713-566-9247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88Y349OtherBCBS
TX104088302Medicaid
TX88Y349Medicare PIN