Provider Demographics
NPI:1922545193
Name:ROMAN, DEBBIE
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23400 KINGSLAND BLVD
Mailing Address - Street 2:APT 13108
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7469
Mailing Address - Country:US
Mailing Address - Phone:713-805-6193
Mailing Address - Fax:
Practice Address - Street 1:23400 KINGSLAND BLVD
Practice Address - Street 2:APT 13108
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7469
Practice Address - Country:US
Practice Address - Phone:713-805-6193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer