Provider Demographics
NPI:1790012375
Name:ROMEO, ANGELA M (PSYD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:ROMEO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8407 GREENBUSH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3232
Mailing Address - Country:US
Mailing Address - Phone:713-306-3329
Mailing Address - Fax:
Practice Address - Street 1:2450 FONDREN RD
Practice Address - Street 2:SUITE 312
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2318
Practice Address - Country:US
Practice Address - Phone:713-789-7560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34222103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB106702Medicare PIN