Provider Demographics
NPI:1912959511
Name:ROMERO, MANUELA (PTA)
Entity type:Individual
Prefix:
First Name:MANUELA
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7430 REMCON CIR
Mailing Address - Street 2:SUITE B110
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3514
Mailing Address - Country:US
Mailing Address - Phone:915-544-2455
Mailing Address - Fax:915-544-3149
Practice Address - Street 1:7430 REMCON CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3514
Practice Address - Country:US
Practice Address - Phone:915-584-0051
Practice Address - Fax:915-584-6764
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2035160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist