Provider Demographics
NPI:1154411304
Name:JAMES R ROMERO MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:JAMES R ROMERO MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:337-229-4214
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:LOREAUVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70552-0278
Mailing Address - Country:US
Mailing Address - Phone:337-229-4214
Mailing Address - Fax:337-229-4065
Practice Address - Street 1:411 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:LOREAUVILLE
Practice Address - State:LA
Practice Address - Zip Code:70552-0278
Practice Address - Country:US
Practice Address - Phone:337-229-4214
Practice Address - Fax:337-229-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1948390Medicaid
193833Medicare Oscar/Certification