Provider Demographics
NPI:1821839242
Name:ROMAN, KRISTIAN LLAJAIRA (LMT)
Entity type:Individual
Prefix:
First Name:KRISTIAN
Middle Name:LLAJAIRA
Last Name:ROMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 FLAGSTONE TRL
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-5886
Mailing Address - Country:US
Mailing Address - Phone:512-627-9446
Mailing Address - Fax:
Practice Address - Street 1:139 FLAGSTONE TRL
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-5886
Practice Address - Country:US
Practice Address - Phone:512-850-6738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist