Provider Demographics
NPI:1821050469
Name:ROMAN, JOSE DANIEL (RN)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:DANIEL
Last Name:ROMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9795 NAOMI DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79927-2815
Mailing Address - Country:US
Mailing Address - Phone:915-858-0725
Mailing Address - Fax:
Practice Address - Street 1:9795 NAOMI DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79927-2815
Practice Address - Country:US
Practice Address - Phone:915-858-0725
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX689797163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine