Provider Demographics
NPI:1851489074
Name:ROMAN, JOE III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:
Last Name:ROMAN
Suffix:III
Gender:M
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:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:BARKER
Mailing Address - State:TX
Mailing Address - Zip Code:77413-0398
Mailing Address - Country:US
Mailing Address - Phone:409-673-0486
Mailing Address - Fax:
Practice Address - Street 1:23247 PARSONS LANDING DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1117
Practice Address - Country:US
Practice Address - Phone:409-673-0486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0772207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB149670Medicare PIN
TXE43701Medicare UPIN