Provider Demographics
NPI:1255367470
Name:SANGALANG, ROMEO B (MD)
Entity type:Individual
Prefix:DR
First Name:ROMEO
Middle Name:B
Last Name:SANGALANG
Suffix:
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 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:806-355-6593
Practice Address - Fax:806-352-8774
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4703207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00181897OtherRAILROAD MEDICARE
00GX27OtherBLUE CROSS
P00181897OtherRAILROAD MEDICARE
00GX27Medicare ID - Type Unspecified