Provider Demographics
NPI:1437634516
Name:ROMANS, WESLEY DOUGLAS
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:DOUGLAS
Last Name:ROMANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W OWING ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4413
Mailing Address - Country:US
Mailing Address - Phone:903-327-9865
Mailing Address - Fax:
Practice Address - Street 1:530 W OWING ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4413
Practice Address - Country:US
Practice Address - Phone:903-327-9865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX322661164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse