Provider Demographics
NPI:1356431613
Name:PIMENTEL ROMAN, MARILYN DAMARYS
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:DAMARYS
Last Name:PIMENTEL ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:D
Other - Last Name:PIMENTEL-ROMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5641 ESPLANADE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4299
Mailing Address - Country:US
Mailing Address - Phone:361-287-0100
Mailing Address - Fax:361-287-0101
Practice Address - Street 1:5641 ESPLANADE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4299
Practice Address - Country:US
Practice Address - Phone:361-287-0100
Practice Address - Fax:361-287-0101
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR579231H00000X
TX80930231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist