Provider Demographics
NPI:1942236062
Name:ROMEO B SANGALANG MDPA
Entity Type:Organization
Organization Name:ROMEO B SANGALANG MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:B
Authorized Official - Last Name:SANGALANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-256-1242
Mailing Address - Street 1:PO BOX 8337
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79114-8337
Mailing Address - Country:US
Mailing Address - Phone:806-355-6593
Mailing Address - Fax:806-352-8774
Practice Address - Street 1:1000 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SHAMROCK
Practice Address - State:TX
Practice Address - Zip Code:79079-2820
Practice Address - Country:US
Practice Address - Phone:806-256-1242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4703207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00GX27Medicaid
00GX27OtherBLUE CROSS
TXP00181897OtherRAILROAD MEDICARE
TX00GX27Medicaid
00GX27Medicare ID - Type Unspecified