Provider Demographics
NPI:1215686100
Name:ROMAN, RUTH INES
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:INES
Last Name:ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9630 TALL MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-6062
Mailing Address - Country:US
Mailing Address - Phone:347-277-9564
Mailing Address - Fax:
Practice Address - Street 1:9630 TALL MEADOW CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-6062
Practice Address - Country:US
Practice Address - Phone:347-277-9564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty