Individual
ROMULO MANUEL BANAAG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2011 N COLLINS BLVD STE 607, RICHARDSON, TX 75080-2636
(800) 640-3451
Mailing address
1515 NORWAY PINE ST, ARLINGTON, TX 76012-2532
(551) 998-1074
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP139528
TX
363LG0600X
Gerontology Nurse Practitioner
AP139528
TX
Other
Enumeration date
11/05/2018
Last updated
02/13/2024
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