Provider Demographics
NPI:1427117753
Name:ROMINE, CHRISTOPHER E (PA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:E
Last Name:ROMINE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7208
Mailing Address - Country:US
Mailing Address - Phone:214-590-4656
Mailing Address - Fax:
Practice Address - Street 1:5200 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7709
Practice Address - Country:US
Practice Address - Phone:214-590-4656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09408363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01424813OtherRAIL ROAD MEDICARE
MN008440000Medicaid
TX75-2616977-008OtherTRICARE
TX8809NMOtherBCBS
TX343271801Medicaid
TX343271801Medicaid
TXP01424813OtherRAIL ROAD MEDICARE
TX75-2616977-008OtherTRICARE
TX384114YMAFMedicare PIN
TX8809NMOtherBCBS