Provider Demographics
NPI:1972507671
Name:AZIZ, ROMMANA (DO)
Entity Type:Individual
Prefix:
First Name:ROMMANA
Middle Name:
Last Name:AZIZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 KELLER SPRINGS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2962
Mailing Address - Country:US
Mailing Address - Phone:972-466-3400
Mailing Address - Fax:
Practice Address - Street 1:1735 KELLER SPRINGS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-2962
Practice Address - Country:US
Practice Address - Phone:972-466-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1675951-01Medicaid
TX8C2682Medicare PIN
TXI17353Medicare UPIN