Individual
ANTONIO ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6116 N CENTRAL EXPY, SUITE 915, DALLAS, TX 75206-5162
(214) 363-2953
(214) 363-2899
Mailing address
110 W SANDY LAKE RD, #102 PMB 105, COPPELL, TX 75019-2015
(214) 363-2953
(214) 363-2899
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J7286
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043901014
—
TX
01
—
1750562237
GROUP NPI
TX
Enumeration date
11/11/2005
Last updated
03/14/2013
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