Provider Demographics
NPI:1669109955
Name:ROMO, HILDA ANGELICA (PT, DPT)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:ANGELICA
Last Name:ROMO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 STANLEY KELLER RD
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117-2224
Mailing Address - Country:US
Mailing Address - Phone:817-617-0705
Mailing Address - Fax:
Practice Address - Street 1:5411 BASSWOOD BLVD STE 225
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-4479
Practice Address - Country:US
Practice Address - Phone:817-498-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1364083225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist