Provider Demographics
NPI:1356692818
Name:IZAGUIRRE PEREIRA, ROMMEL ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:ROMMEL
Middle Name:ALBERTO
Last Name:IZAGUIRRE PEREIRA
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 1:4828 LIBERTY AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2137
Mailing Address - Country:US
Mailing Address - Phone:412-209-9430
Mailing Address - Fax:
Practice Address - Street 1:700 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-5552
Practice Address - Country:US
Practice Address - Phone:409-747-5823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282NC2000X
TX47988207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No282NC2000XHospitalsGeneral Acute Care HospitalChildren