Provider Demographics
NPI:1821010786
Name:ORESTES ROMERO MD PA
Entity Type:Organization
Organization Name:ORESTES ROMERO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORESTES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-570-1200
Mailing Address - Street 1:PO BOX 4258
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903-4258
Mailing Address - Country:US
Mailing Address - Phone:361-570-1200
Mailing Address - Fax:361-570-1220
Practice Address - Street 1:601 E SAN ANTONIO ST
Practice Address - Street 2:STE 205 W
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6002
Practice Address - Country:US
Practice Address - Phone:361-570-1200
Practice Address - Fax:361-570-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0020LZOtherBLUE CROSS
TX167236201Medicaid
TX00160XMedicare PIN
TXDC6206Medicare PIN