Provider Demographics
NPI:1871826818
Name:ROMERO, ROBERTA ANGELICA (FNP)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:ANGELICA
Last Name:ROMERO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 EWING HALSELL DR FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3707
Mailing Address - Country:US
Mailing Address - Phone:210-575-4837
Mailing Address - Fax:210-575-8480
Practice Address - Street 1:8201 EWING HALSELL DR FL 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3707
Practice Address - Country:US
Practice Address - Phone:210-575-4837
Practice Address - Fax:210-575-8480
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP118454363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX796170OtherMCR PTAN