Individual
DR. MICHAEL A ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4242 MEDICAL DR STE 7100, SAN ANTONIO, TX 78229-5397
(210) 342-1906
(210) 570-8203
Mailing address
4242 MEDICAL DR STE 7100, SAN ANTONIO, TX 78229-5397
(210) 342-1906
(210) 570-8203
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
24435
TX
103T00000X
Psychologist
24435
TX
103TC0700X
Clinical Psychologist
24435
TX
103TS0200X
School Psychologist
30235
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110626202
—
TX
01
—
243539000
MAGELLAN BEHAVIORAL HEALT
TX
01
—
285657
VALUE OPTIONS
TX
Enumeration date
11/30/2005
Last updated
04/30/2024
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